Five Reasons to Focus on Medicare Annual Wellness Visits

Jul 09, 2024


The Medicare Annual Wellness Visit (AWV) is one of the more powerful tools in a provider’s arsenal for promoting patient and practice health. Different than an annual physical, AWVs are designed specifically to encourage an in-depth conversation with patients to help gauge their current health, review medications and immunizations, set a baseline for current health, and identify possible future health concerns.

There are many reasons to ensure patients receive their AWVs once every year. Here are just a few.

It Helps Coordinate Better Care – The AWV provides a focused template to update info, reconcile medications, and order necessary screenings and vaccinations. They also provide an opportunity to talk with the patient about whole health and preventive care, encouraging them to become involved in their own healthcare journey for improved health.
It Helps Capture Required Quality Metrics – When conducted correctly, an Annual Wellness Visit can help you to capture and document up to 80% of the required HEDIS and STARs measures required by all Medicare plans. Proper capture and reporting of these measures is vital to maximizing benchmarks and reimbursement levels.
Improved Hierarchical Condition Category (HCC) Risk Scores – HCCs rank diagnoses into categories that represent conditions with similar disease and cost patterns. The program is prospective and uses health status in the previous year to predict costs in the following year. Risk scores are used by CMS to establish risk adjusted payment rates which are generally passed downstream. It is very important to receive the necessary payment to properly care for the patients.
It Helps with Patient Satisfaction and Retention – The AWV is a golden opportunity for physicians and clinical staff to spend quality one-on-one time with the patient. The resulting conversation helps encourage communication and trust, while identifying additional opportunities for follow-up and preventive care.
Most Importantly, It’s Good for Patients – Annual Wellness Visits can help identify and reduce future health problems, helping patients to enjoy a better quality of life.

Additionally, many health plans have various AWV programs to encourage these visits and in some cases, there are IPA, clinic/provider and or member incentives associated with them. For assistance implementing Annual Wellness Visit programs, please contact MedPOINT’s Quality Management department, or click the links below to review AWV documents from our online provider library:

MPM Medicare Annual Wellness Visit Requirements

April 2019 Provider Quality Newsletter – Under Care for Older Adults, page 8

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