Care Management Blog

In this video, we discuss how Annual Wellness Visits — or AWVs — can be a powerful gateway to enrolling patients in care management programs like Chronic Care Management (CCM) and Remote Patient Monitoring (RPM). We’ll show you why AWVs are more than just a Medicare requirement — they’re a key touchpoint for identifying patient needs, improving outcomes, and boosting reimbursement for your practice. If you're looking to deliver more holistic care and grow your value-based care efforts, you're in the right place.

Launching or expanding a care management program comes with certain challenges.

The Centers for Medicare & Medicaid Services (CMS) allows billing practitioners to collaborate with third-party care management service companies. This arrangement can provide external clinical staff and non-clinical staff to perform certain care tasks.

Providers and third-party service companies want to deliver accessible and convenient care that has an impact.

Ineffective transitions of care challenge providers Readmission rates have remained high despite the Hospital Readmission Reduction Program (HRRP). The average US all-cause readmission rate is 14.56%, and it ranges from 11.2% to 22.3% across states. Other value-based care programs, where reimbursement is tied to the quality of service, haven’t led to a significant change in readmissions, either.

A recent AARP bulletin story by Dr. Howard Zucker asks, "Where have all the doctors gone?"

Health equity can play a vital role in enhancing and optimizing care delivery across populations.

Annual Wellness Visits (AWVs) go beyond a yearly evaluation. The AWV provides a means to achieving several goals, including:

Clinicians and healthcare policymakers are accepting that physical and mental health are closely interconnected. This view is now influencing the aims and focus of value-based care through Chronic Care Management, care coordination, and Integrated Behavioral Health.

Annual Wellness Visits (AWV) for Medicare beneficiaries can add measurable value to benefit patient health outcomes, quality performance, and service revenue. However, it’s critical to optimize physician and staff time with a reliable, standards-based, and streamlined workflow.