Medicare Wellness VisitsMedicare beneficiaries are eligible to receive a free Annual Wellness Visit (AWV), which Medicare introduced in 2011. According to the research report from Brigham and Women’s Hospital, published in Health Affairs, practices that offer free wellness visits saw increase in their primary care revenue and stability of patient assignment – that is, patients were more likely to stay with the practice for a given three-year time period. Introduced under the Affordable Care Act to promote evidence-based preventive care, AWV is designed to update a patient’s current medical record and screen for certain high risk conditions including screening for depression and risk of falls. Medical coding services offered by an experienced coding team can help physicians accurately document the purpose and scope of these visits.

Annual Wellness Visit includes review of medical and family history, height, weight, blood pressure, and other routine measurements, detection of any cognitive impairment, personalized health advice, and a screening schedule (like a checklist) for appropriate preventive services. This plan is designed to help prevent disease and disability based on your current health and risk factors. Additional tests or services performed during this visit aren’t covered under the preventive benefits.

To assess practices’ ability and motivation to adopt the visit, the research team evaluated national Medicare data for the period 2008-15. They noted that in 2015, 51.2% of practices provided no annual wellness visits, while 23.1% provided visits to at least a quarter of their eligible beneficiaries (adopters).

Other key findings include

  • Medicare Wellness Visits Increased Practice RevenueOverall, just 18.8% of all eligible beneficiaries received a wellness visit
  • Hospital-based practices were less likely than independent practices to provide the visits
  • Visit rates were lower among practices caring for underserved populations such as racial minorities and those dually enrolled in Medicaid.
  • Adopters replaced problem-based visits with annual wellness visits and saw increase in primary care revenue.
  • Primary care practices may be missing out on income, as Medicare pays more for wellness visits than for problem-based visits.
  • Offering wellness visits was linked to more stability with patient assignments and a slightly healthier patient mix, according to Hierarchical Condition Category (HCC) risk scores.

The report also recommends policy makers to encourage uptake of the visit or other mechanisms to promote preventive care in underserved populations and the practices that serve them. Extending programs such as Comprehensive Primary Care Plus can help primary care practices to be compensated for caring for complex patients outside of traditional visits. Medical billing and coding outsourcing helps providers to save time and focus on such visits.