Annual Wellness Visits (AWVs): A Complete Guide to Improving Patient Outcomes and Practice Performance

Annual Wellness Visits (AWVs) are one of the most powerful—yet underutilized—tools available to healthcare providers today. As the industry continues shifting toward value-based care, AWVs offer a unique opportunity to improve patient outcomes, increase reimbursement, and strengthen long-term engagement.

In this article, we break down key insights from an episode of Off the Chart with Medical Economics podcast conversation with Dan Godla, Founder & Chief Strategy Officer of ThoroughCare, to help you understand how to successfully implement and scale AWVs in your practice.

What Is an Annual Wellness Visit (AWV)?

An Annual Wellness Visit (AWV) is a Medicare-covered preventive service designed to assess a patient’s overall health and develop a personalized prevention plan.

Unlike a traditional physical exam, an AWV:

• Focuses on Health Risk Assessments (HRAs)
• Reviews medical and family history
• Screens for cognitive, behavioral, and functional risks
• Establishes a 5–10 year preventive care roadmap

AWVs are not about diagnosing current conditions—they are about identifying risks before they become serious health issues.

AWV vs. Physical Exam: What’s the Difference?

Many providers mistakenly treat AWVs like routine physicals—but they serve different purposes.

AWVs are designed by Medicare to proactively manage patient health, while physical exams address current medical issues.

Why AWVs Matter in Value-Based Care

As healthcare transitions from fee-for-service to value-based models, AWVs play a critical role in bridging the gap.

1. Improve Quality Metrics

AWVs help providers track and address key performance measures such as:

• Fall risk assessments
• Diabetes management (A1C, eye exams, foot exams)
• Preventive screenings (colonoscopy, cholesterol tests)

By systematically capturing this data, practices can improve performance across programs like MIPS and ACOs.

2. Increase Preventive Care Engagement

The health risk assessment drives actionable insights:

• Identify fall risks → schedule home safety interventions
• Detect depression/anxiety → refer to behavioral health
• Highlight care gaps → recommend screenings and vaccines

Patients leave with a clear, personalized care plan, increasing adherence and engagement.

3. Generate Sustainable Revenue

AWVs are reimbursable by Medicare, typically ranging from:

• ~$150 for initial visits
• ~$110–$120 for subsequent visits

Even better:

• $0 copay for patients
• Can be partially completed by clinical staff
• Opens the door to additional reimbursable services (e.g., CCM, RPM)

This makes AWVs a rare “win-win” for both financial performance and patient care.

How AWVs Fit into Fee-for-Service and Value-Based Models

AWVs are uniquely positioned to support both reimbursement models:

• Fee-for-Service: Direct reimbursement for each visit
• Value-Based Care: Improved outcomes, reduced hospitalizations, and better quality scores

Rather than choosing one model over the other, AWVs allow providers to get paid while improving long-term patient health.

Overcoming Common Challenges with AWVs

Despite their benefits, many practices hesitate to implement AWVs due to operational concerns.

Challenge 1: Limited Time

Solution: Delegate tasks

• Clinical staff (RNs, MAs) can complete up to 80% of the visit
• Physicians focus on reviewing risks and care planning (~15 minutes)

Challenge 2: Staffing Constraints

Solution: Optimize workflows

• Conduct HRAs before or during visits
• Use team-based care models

Challenge 3: Complexity and Compliance

Solution: Use structured protocols

• Follow CMS guidelines step-by-step
• Ensure all required elements are documented

How Technology Simplifies AWVs

Technology plays a crucial role in scaling AWV programs efficiently.

Key Benefits of AWV Software:

• Automated risk analysis: Instantly flags patient risks from HRA responses
• Workflow optimization: Guides staff through required steps
• Accurate documentation: Reduces audit risk
• Billing support: Ensures correct codes and modifiers are used

Instead of manually reviewing patient responses, providers can rely on software to surface insights and streamline decision-making.

Enhancing the Patient Experience

One of the most overlooked advantages of AWVs is the patient experience.

Successful practices treat AWVs as:

• A consultative conversation, not a clinical task
• A comfortable, personalized interaction (sometimes even outside exam rooms)
• An opportunity for patients to feel heard and supported

Because AWVs are fully covered by Medicare, patients are more likely to participate—and often leave with higher satisfaction.

Best Practices for Implementing AWVs

To get started with AWVs in your practice:

1. Start small – Pilot with a subset of patients
2. Train your care team – Delegate responsibilities effectively
3. Standardize workflows – Use checklists or software tools
4. Educate patients – Position AWVs as a free, valuable benefit
5. Track outcomes – Monitor quality metrics and engagement

The Bottom Line: Why AWVs Are a Win-Win

Annual Wellness Visits deliver measurable benefits across the board:

For Patients:

• Preventive, proactive care
• Personalized health planning
• No out-of-pocket cost

For Providers:

• Increased reimbursement
• Improved quality scores
• Stronger patient relationships

For Healthcare Systems:

• Reduced hospitalizations
• Better population health outcomes
• Progress toward value-based care goals

Frequently Asked Questions (FAQ)

What is included in an Annual Wellness Visit?

An AWV includes a health risk assessment, medical history review, cognitive and behavioral screenings, and a personalized preventive care plan.

How often can patients receive an AWV?

Medicare covers one AWV per year at no cost to the patient.

Can AWVs be delegated to staff?

Yes. Clinical staff can perform most components, with the provider reviewing results and finalizing the care plan.

Are AWVs the same as physical exams?

No. AWVs focus on prevention and long-term planning, while physical exams focus on diagnosing current conditions.

Final Thoughts

Annual Wellness Visits are more than just a Medicare requirement—they’re a strategic advantage. By combining preventive care, patient engagement, and financial sustainability, AWVs help practices thrive in an increasingly value-driven healthcare landscape.

If you’re not already offering AWVs, now is the time to start.