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Annual Wellness Visit

How An Annual Wellness Visit Can Promote Preventive Health Services

July 29th, 2021 | 6 min. read



Content Team

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Despite the noted benefits of preventive care, only 8% of adults in the United States receive all appropriate services, according to the Centers for Disease Control and Prevention (CDC). Nearly 5% receive nothing.

How can this be?

Lack of awareness holds cause for patients. And financial considerations worry healthcare organizations, restricting overall access. 

The value of an Annual Wellness Visit (AWV), for doctors and patients, alike, is that it is a chance to take stock of what is going well and what can be improved. It can also identify preventive health services that patients may lack awareness of, such as Behavioral Health Integration (BHI) or Chronic Care Management (CCM).

These can help align preventive priorities and direct future treatment. 

At ThoroughCare, we’ve developed a care coordination software solution to address both concerns, especially when providing an AWV or other preventive services. Clinics and physician practices across the US use our solution. 

Our platform simplifies the management of several preventive Medicare programs, enabling effective, cost-efficient care for doctors and patients. 

In this article, we’ll review what an AWV is, how it can identify areas of treatment, and how software will streamline the process, as well as foster new revenue opportunities

What is an Annual Wellness Visit (AWV)?

An AWV is a yearly assessment of one’s current health. It is entirely FREE for anyone covered by Medicare Part B

A doctor uses the time to discuss health history, identify potential issues and answer an individual’s questions. The overall goal is to establish a record of a person’s physical and mental well-being for the purpose of preventive health planning. 

An AWV should not be confused with a routine physical examination. The AWV is more about recognizing possible gaps in a patient’s healthcare and planning the next steps. It should include:

  • A review of medical and family history.
  • Developing or updating a list of current providers and prescriptions.
  • Height, weight, blood pressure, and other routine measurements.
  • Detection of cognitive impairment.
  • Personalized health advice.
  • A screening schedule (or checklist) for appropriate preventive services. 

By participating, a patient will receive a personalized risk prevention plan, targeted for specific diseases or disabilities relevant to their situation.     

A Health Risk Assessment (HRA) is a central part of the AWV. It drives the initial visit. It is a questionnaire and screening tool, and upon its completion, it provides the patient and doctor with action items. 

What Questions Does a Health Risk Assessment Ask?

The HRA requires about 20 minutes to complete. It is the first part of participating in an AWV.

Medicare expects it to be finished prior to or during the annual wellness visit. A patient may also take the assessment at home, either online or over the phone

The HRA inquires about the following: 

  • Demographics – age, gender, etc.
  • Self-assessment of health/lifestyle – exercise, eating habits, alcohol, and tobacco use.
  • Activities of daily living (ADLs) – dressing, bathing, walking; including instrumental ADLs like shopping, housekeeping, medication management, etc.
  • Emotional health – mood, stress, life events.
  • Physical health – weight, blood pressure, cholesterol levels.
  • Medical history – current and previous health conditions.

To make the most of a patient’s health risk assessment, consider these five best practices.

The Outcome of an Annual Wellness Visit (AWV)

As stated above, an AWV will provide a patient with a personalized risk prevention plan

But what exactly does that mean? It’s pretty simple. 

By completing the HRA, a patient inputs specific information, and their doctor helps extract and contextualize this data. They either apply it to treatment methods, or highlight areas of concern. 

Some care management software automates this process, providing recommendations itself. 

Doctors then use the completed HRA to create a patient care plan. It can include ongoing, preventive services, as well as general health management, for the next five to 10 years

This is where a good dialogue between a care provider and a patient is critical. Collaborative decision-making will help determine the best next steps. 

Shared Decision-Making for Next Steps

There’s much to discuss during an AWV, but what’s important to the patient?

Based on the completed HRA, you should ask the patient what their priorities are. 

Are they worried about anything specific? If so, what and why?  

Once this is identified, provide your professional input. Highlight any other high-priority health risks that should be discussed and treated.  

In this stage of discussion, you can recommend, if relevant, other preventive Medicare services. Especially if there is common ground between your and the patient’s key concerns.  

For example, if a patient sees hypertension as a priority for treatment, review the benefits of Chronic Care Management (CCM)

Explain how the program can support ongoing intervention outside the typical doctor’s appointment. If the patient is covered by Medicare Part B, their insurance will cover up to 80% of CCM costs — alleviating financial concerns. 

As the provider, you can use the AWV as an opportunity to enroll individuals in new services. This will equip patients with valuable resources previously unavailable to them. Providers can also be reimbursed for offering AWVs.

Rates vary depending on the type of AWV provided and the provider's location. Please search the Physician Fee Schedule from CMS for the latest information. 

Additionally, the AWV may identify further tests, vaccinations, or health screenings vital for the patient. 

While enrolling a patient in CCM is one possibility following the AWV, other services may be required. These will also boost practice revenue.

Software Makes This All The More Efficient

Manual care coordination requires substantial staff time. 

The more patients you manage, the higher your expenses will accrue.

Care coordination software drastically reduces this cost through automation

For an AWV, software can:

  • Streamline the HRA
  • Recommend next steps based on answers to the assessment
  • Create a patient-centered care plan
  • Create patient letters, reports, and educational materials
  • Create provider documents for sign-off  

If an AWV leads to participation in CCM or Behavioral Health Integration (BHI), software will utilize the patient-centered care plan on file to speed up enrollment

There’s also the benefit of billing features. These can ensure accuracy in claims, protecting you against potential audits.

ThoroughCare’s solution provides for all of this

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