Every day in the United States, 10,000 people turn 65, and this astonishing
trend is expected to continue for 20 years. Never in the history of the
United States, or the world for that matter, have this many people over
the age of 65 been alive. It is our responsibility as physicians to maintain
the health of this aging population and to help restore their health when
One very underutilized tool which can assist us with this is the Annual
Wellness Visit (AWV). The intent of AWVs is to enable Medicare beneficiaries
to receive recommended preventative services to support a healthier life
by way of disease prevention, early detection and lifestyle modification.
The potential to reduce hospitalizations and more serious health problems
for Medicare patients is clearly a benefit of performing AWVs.
Intended primarily as a benefit for patients, there is value for primary
care providers as well. The reimbursement for AWVs is attractive at $173
for an initial visit and $117 for subsequent AWV visits. Practices that
employed AWVs on at least 25% of their patients generated greater practice
revenue, while nonadopters saw a slight decline in their revenue. AWVs
will also help improve quality measure performance as 18 quality measures
are incorporated in the AWV. In addition, AWVs will help increase our
NextGen attribution. This is particularly important with healthier Medicare
patients whose attribution will drop off if they are not evaluated in
an office at least once per year. A benefit to the Alliance is that these
patients generally have a lower per member per year (PMPY) spend which
will lower our aggregate PMPY spend and increase our financial performance.
Yet a recent national survey revealed less that 20% of Medicare patients
receive a wellness visit. In addition, nationally more than 50% of PCPs
offer no AWVs in their practice. Last month, the Alliance held a PCP town
hall meeting to address the value associated with performing AWVs and
how different practices within the Alliance are pursuing this goal. We
will be happy to share those processes with any providers who are interested.
I believe there is a clear benefit to our Medicare patients, to our PCP
providers and also to the Alliance in performing AWVs. To that point,
the Alliance should set goals for what percentage of eligible patients
receive AWVs annually. Ultimately, I would like to see this target be
80%. I envision this becoming a performance metric we utilize to gauge
our annual physician performance distribution.