Medicare Wellness Visits: Reassessing Their Value to Your Patients and Your Practice

Arnold E. Cuenca, DO, Caqsm, FAAFP; Susan Kapsner, CCS

Disclosures

Fam Pract Manag. 2019;26(2):25-30. 

In This Article

Abstract and Introduction

Introduction

Providing Medicare wellness visits can be challenging but can improve quality and practice revenue.

The Affordable Care Act of 2010 created the Medicare annual wellness visit (AWV) as a way to provide patients with comprehensive preventive care services at no cost. Yet many practices have been slow to provide substantial numbers of these visits. Only 15.6 percent of eligible patients received an AWV through 2014.[1] In addition to finding lackluster overall participation, researchers have found AWV rates are lower among practices caring for underserved populations, such as racial minorities, rural residents, or those dually enrolled in Medicaid.[2]

Physicians and other health care providers do not offer AWVs to their Medicare patients for numerous reasons. Providing and documenting all of the required AWV elements efficiently can be challenging, and some practices may feel their staffing or electronic health record resources are too limited. Many patients and even some physicians may not know what the AWV entails, and patients with complex socioeconomic risk factors may have pressing health conditions that need to take priority over preventive services. These explanations can all be valid, but this article seeks to help physicians reevaluate the AWV, along with the initial preventive physical examination (IPPE) or "Welcome to Medicare" visit, and recognize the value these wellness visits can bring not only to their patients but also to their practices or health care organizations.

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