By Shelly Rogers, M.D. Mt. Sterling Clinic
Of all the things a family physician does, helping people maintain their health is one of the most important. After all, it’s far preferable to stay healthy than to try to regain health. Recognizing this, the Centers for Medicare and Medicaid Services (CMS) began offering a new benefit to Medicare beneficiaries in 2011 that provided the opportunity for physician and patient to sit down together to develop a plan to prevent disease and disability.
This benefit is called the Annual Wellness Visit.
In the first year the AWV was offered, only 8 percent of those eligible took advantage of it. By 2014, the number rose to 16 percent, a shamefully low participation rate, especially because the AWV is provided free – no copay, no deductible – to those enrolled in Medicare Part B for at least 12 months.
Why are participation rates so low? First, and most importantly, the majority of Medicare beneficiaries don’t know about the benefit. This is especially true of patients who enrolled in Medicare before 2011. Secondly, beneficiaries who know about the AWV may be confused about its purpose.
As you would expect with any program administered by Medicare, the Annual Wellness Visit is quite structured, with the specific items to be covered during the visit. Don’t be surprised if your provider uses a checklist to ensure compliance with AWV requirements, which include:
• A review of your personal and family medical history
• An update of your current providers and prescription medications you’re taking
• Measurements of your height, weight and blood pressure.
• Questions around your cognitive ability
• A review of your risk factors and a discussion of options to reduce or manage those risks
• A discussion and review of preventive screenings that are recommended for someone your age and gender (colonoscopy, DEXA, mammography, etc.)
• A discussion about advance care planning/end-of-life care
As part of the AWV, the physician/provider will review the patient’s answers to a somewhat lengthy Health Risk Assessment. The HRA asks patients to evaluate their overall health; whether they take prescription medications, how many, and as prescribed; about their dental/oral health; visits to the ER in the past six months; and hospital admissions over the past six months.
It also includes questions about tobacco, alcohol and substance abuse (and whether you need help to stop); length and quality of sleep; and your ability to complete routine self-care tasks such as toileting and bathing, shopping and cooking and so on. Nutrition, physical activity, the ability to see and hear are also part of the HRA.
Mt. Sterling Clinic