By DEREK ESTY
With the passing of the affordable care act, Medicare established a new benefit for all beneficiaries, the Annual Wellness Visit (AWV). This recent benefit visit is designed for all beneficiaries to have an opportunity to discuss their health with their providers, to build a plan of care, to help manage current medical concerns and prevent new ones from forming. AWSs are not the most profitable Medicare visit a practice can perform and have no cost to the beneficiary since all costs are covered at one hundred percent with no copay deductible to the patient.
AWVs are designed for the patient to engage with their providers for an individualized long-term treatment plan of care to ensure that healthy patients stay that way, and sick patients do not worsen. Most patients and, sadly, many providers do not understand what AWVs are or how to perform them. The Centers for Disease Control (CDC) and Medicare have calculated that less than twenty percent of all Medicare beneficiaries received them last year. In fact, those same studies have shown that patients who received the visits saved Medicare over five percent in annual costs and have improved patients’ lives not only in quality, but also in longevity.
Both providers and patients confuse AWVs with a yearly physical, but the AWV is something else altogether. Yearly physicals focus on the current condition of the patient. AWVs identify ways to keep the patient healthier longer and prevent illnesses from starting or worsening. A significant focus of the annual wellness visit is to ensure that patients have access to all the services Medicare suggests, like preventive care, annual screenings (mammogram, colonoscopy, etc.), immunizations, and other missed services by busy practices. AWVs focus on lifestyle changes, understanding family history, and how the patient can have a life free from disease instead of just treating disease. Patients and providers build a plan of care to help keep that patient healthier longer and address areas that both the patient and the provider need to ensure a better health outcome.
The requirements for an AWV set by Medicare are why the visits are underutilized. The visit requires the practice to collect and store a large quantity of data about the patient, allowing them to develop treatment plans for existing conditions and annual wellness plans to help prevent future illness. Today, many practices do not have a system to gather all the information required to complete the annual wellness visit, let alone the time needed to review the information with the patient. Most of what makes up an AWV is gathering and studying patient information and building a treatment plan for care. Still, most practices do not have the time or the staff to accomplish this goal, with medicine changing to more outcome-based versus fee-for-service. Medical practices that adapt now will provide the best care possible and ensure profitability in the future.
Don’t forget that Medicare requires that practices complete AWVs on 60 percent of their Medicare patients this year. How are you doing?
Derek Esty is COO for ThoughtSwift, an early-stage medical software provider of Medical Assessments to Primary Care & Internal Medicine Physicians. Esty created ThoughtSwift with a goal of helping doctors generate additional revenue while providing the highest level of care.
RX2Live is a Health and Wellness Services Company positioned to advance healthcare through the BHS platform. We have been able to help our physicians open better paths of communication with their patients, limit hospital readmissions, diagnose and treat conditions that otherwise might have gone unnoticed and create an environment where the practice or facility can thrive and realize additional growth.
Visit RX2Live or email John Fogarty at Jfogarty@RX2Live.com
John Fogarty is regional Developer for RX2Live. He has spent 21 years in nuclear generation, transmission and distribution. He holds a master’s in International Management. He became an RX2Live developer to improve patient care and help providers and practices succeed.