Annual Wellness Visits (AWVs) are key for staying up to date on patient medical conditions, improving care outcomes and quality, optimizing revenue, and closing gaps in care across populations. With the shift to value-based care, Annual Wellness Visits have also become crucial to reducing costs and hospital utilization.
But while Annual Wellness Visits have been around for several years, many healthcare organizations and providers are still confused about what they are exactly, why they are important, and how they can improve their Annual Wellness Visit completion rate.
What are Annual Wellness Visits? Why are Annual Wellness Visits important?
“Annual Wellness Visits essentially refer to visits which fall into one of three categories, as outlined by the Centers for Medicare and Medicaid Services, or CMS,” said Brandy Smuzeski, a Licensed Master of Social Work who works closely with ACOs (Accountable Care Organizations) and other clients to help them improve in areas including Annual Wellness Visits.
“In the first category, Annual Wellness Visit may refer to an Initial Preventive Physical Examination (IPPE) which must be conducted within the first twelve months of a patient enrolling in Medicare – the IPPE is also referred to as a Welcome to Medicare Visit,” Smuzeski continued. “If a patient misses the IPPE, the second category they are eligible for is the Initial Annual Wellness Visit, which can be performed twelve months and one day after enrollment into Medicare. This visit is similar to the Welcome to Medicare Visit, as it is only available once per lifetime. After an IPPE or an Initial Annual Wellness Visit, the third category is called the Subsequent Annual Wellness Visit, which occurs annually, 12 months after the prior Annual Wellness Visit.”
By checking in each year to ensure that patients understand their diseases, diagnoses, and directions for treatment, AWVs help to improve patient engagement and encourage patients to be more involved in their own preventative care. Case studies and other evidence exists to support the notion that increased patient engagement leads to improved outcomes.
Many providers are looking to Annual Wellness Visits as a solution to recover from the devastating revenue losses of 2020 due to the pandemic. Medical practices, hospitals, and other healthcare organizations have been effective in getting patients reengaged with care by bringing them back in for Annual Wellness Visits.
Annual Wellness Visit Case Study: Improved Patient Engagement, Reduced Patient Cost
Recently, Smuzeski worked on a project with the Professional Medical Corporation, (PMC), an Affordable Care Organization (ACO) in Flint, Michigan, to focus on increasing AWV Completion rates. The project started with an analytics deep dive into how PMC was currently performing in a variety of areas to determine where the biggest opportunities for improvement were.
“Once we had identified Annual Wellness Visits as one of the potential areas for improvement – especially in an area like Flint, where preventative care is all the more important – we started realizing how big of an opportunity we had to improve care and outcomes,” Smuzeski said.
From there, Smuzeski and her team created a series of initiatives and strategies targeted at increasing the visit completion rate. These strategies included reaching out to physicians to:
- Train them on the rules and framework around AWVs within CMS,
- Create explainer packages,
- Design operations workflows,
- Tailor EHR templates to help practices document Annual Wellness Visits,
- Deploy an onsite care manager to walk through the visit process.
The results were impressive. Some practices in the ACO went from completing zero Annual Wellness Visits for the year to nearly 80% of their patients completing AWVs. Across the entirety of practices within the ACO, Smuzeski and team were able to achieve north of a 75.5% Annual Wellness Visit completion rate – compared to the national average of 20-24%.
Costs for patient care likely decreased as well – according to Smuzeski, the completion of an Annual Wellness Visit is associated with a 5.7% drop in that patient’s healthcare cost, with the largest decrease in costs coming from patients with the most hierarchical condition category (HCC) codes.
“We’ve been really impressed with the engagement that we’ve had from our practices that we work with from the physicians, and from the patients working alongside their providers to complete the visit,” Smuzeski said.
Annual Wellness Visit Completion Rate: Medical Advantage Can Help
With a robust Annual Wellness Visit strategy and completion rate, patients become more involved with their health and care plans which boosts patient engagement – as well as satisfaction and patient outcomes.
To achieve improvement targets, our care management services, which include the AWVs strategy, help hit metrics, reduce cost, and improve quality. Medical Advantage’s consultants also provide EHR Consulting to help streamline visits into practice workflows, ensure staff are trained in new workflows, and help to ensure proper reimbursement for practices, amongst other services.
“Everything we offer in the way of services is individualized. Whether it’s focused on transition of care, Annual Wellness Visits, advance care planning, or other critical components of patient health and outcomes – when we get involved with a client, often, we help them with additional service lines as well,” Smuzeski said.
Don’t wait to leverage Annual Wellness Visits as a powerful means to increase patient engagement, boost revenue, improve outcomes, and reduce costs. Contact Medical Advantage for a free consultation today.