Description of the Annual Wellness Visit

Abstract

The Medicare Annual Wellness Visit (AWV) was introduced in 2011 as part of the Medicare Part B expansion under the Affordable Care Act. The purpose of the AWV was to encourage preventive care and mitigate health risks in aging patients through required, age-appropriate, and risk-modifying screenings and assessments. The intention was to change the focus away from acute medical problems , and have patients and providers engage in a conversation that focused on health history, health behaviors, and prevention. The overall goal of the AWV was to create a plan of care that addresses prevention and/or the optimal management of clinical problems (Centers for Medicare and Medicaid, 2018). Eligibility Individuals are eligible for an AWV if they have Part B coverage from Medicare. In the first year of transition to Medicare, a "Welcome to Medicare" preventive visit is done instead of an AWV. The AWV can start the year following the Welcome to Medicare visit. Only one visit per year is allowed (Centers for Medicare and Medicaid, 2018). What is Covered Under the AWV The AWV is not a comprehensive physical exam. This is often surprising for patients, who traditionally expect this type of exam when seeing a health care provider. Rather, the AWV involves more talking than direct touch. The health care provider evaluates routine biometric assessments, including height, weight, and blood pressure, and reviews the patient's past medical history and family history, as relevant. Additional assessments are based on questionnaires and screening tools, which can vary from provider to provider. These assessments include an evaluation of cogni-tion, mood, balance, vision, hearing, risk of falls, basic and instrumental activities of daily living (e.g., preparing meals and taking medications), current immunization status, safety factors (e.g., fall prevention, seat belt use, neighborhood safety), status of cancer screenings, and completion of advanced directives. In addition, the provider should develop a current medication list; develop a list of health care providers (e.g., specialists, as relevant for the patient); note the use of durable equipment, such as oxygen, and the supplier; and create an updated list of immunizations and screenings, with dates and results. A five-to ten-year screening schedule should be established. Coverage and Costs Associated with the AWV Medicare covers the AWV at 100% of the Medicare-approved amount when the service is provided by a participating provider. Medicare Advantage plans are required to cover AWVs without applying deductibles, copayments, or coinsurance when the patient is seen by an in-network provider. In the event that a problem is identified during the AWV that requires additional testing (e.g., there are concerns about anemia and blood work is done), Medicare The purpose of the AWV was to encourage preventive care and mitigate health risks in aging patients through required age-appropriate and risk modifying screenings and assessments.