The Medicare Annual Wellness Visit: A Tool for Planning Patient Care
Posted by PHN Communications | Jun 12, 2024 | Featured News
We value wellness exams and assessments because of the potential to improve overall health and well-being. Medicare annual wellness visits (AWVs) are an important way to enhance patient engagement and experience, because they offer valuable opportunities for patients to connect with you, ask questions and receive personalized guidance for their health journey.
We encourage you to conduct an AWV with your Peoples Health patients once each year. This is a fully covered, no-cost benefit for patients. And for you, it’s a valuable tool to assist in developing comprehensive care plans, in that it focuses on maintaining a full health history, identifying health risks and implementing personalized screening schedules.
Peoples Health plan members are covered for one initial AWV per lifetime and one subsequent AWV per calendar year. The initial AWV establishes required elements; subsequent AWVs are to update elements.
An AWV must meet certain criteria. We follow Medicare guidelines for the required elements, which are summarized below. Reference full guidelines, including coding requirements, at cms.gov.
- Perform or review a health risk assessment, including demographic data, a health status self-assessment, psychosocial and behavioral risks, activities of daily living, and instrumental activities of daily living
- Establish or update a medical and family history record, including medical events that pose increased risk, past medical and surgical history, and use of medications and supplements
- Establish or update a list of current medical care providers and suppliers
- Measure height, weight, body mass index, blood pressure and other routine measurements
- Assess for cognitive impairment
- Review potential depression risk factors, including current or past experiences with depression or other mood disorders (initial AWV requirement; can be provided and billed separately in subsequent AWVs)
- Review functional ability and level of safety
- Establish or update a screening schedule for the next five to 10 years, as appropriate
- Establish or update a list of risk factors and conditions where primary, secondary or tertiary interventions are recommended or underway, including mental health conditions such as depression, substance use disorders and cognitive impairment
- Provide or update personalized health advice and appropriate referrals to health education or preventive counseling services or programs to reduce health risks and promote self-management and wellness, including around fall prevention, nutrition, physical activity, tobacco use cessation, weight loss and cognition
- Review current opioid prescriptions
- Screen for potential substance use disorder
- Optional: Provide advance care planning services, such as advance directive preparation, at patient’s discretion
- Optional: Conduct social determinants of health risk assessment
Encourage patients to bring a full list of medications and supplements to their AWV. Assess these for appropriate and continued use. Consider prescribing long-term supplies of maintenance medications.* And encourage the use of a mail-order pharmacy for more convenient access through home delivery. Read more about the benefits of a long-term supply and home delivery.
*Most Peoples Health plan members are covered for a long-term supply of 100 days. Members in Peoples Health Group Medicare plans are covered for a 90-day supply.
EDUCATIONAL VIDEOS
ARTICLES BY CATEGORY
