Barriers to the Annual Wellness Visit

The Medicare Annual Wellness Visit (AWV) is one of the key components to changing healthcare in the United States for the better. And, the wellness visit has the capability of improving quality, decreasing costs, and engaging patients now and in the future.

So why are physicians conducting so few wellness visits? Why are beneficiaries not inquiring or demanding these visits from their primary physician? Awareness is at the root of both answers. Medicare, AARP nor state health authorities seem to be doing anything meaningful to change the low adoption rate in New Jersey or anywhere else in the county for that matter. So why are awareness and adoption levels so low. Here are some reasons that may contribute to these answers:

1. The Annual Wellness Visit is complex, has many components, and is time consuming. This may be true if the provider is still practicing medicine in a manual or paper environment. But now there are IT tools to make the visit less time consuming and efficient. CMS encourages innovative ideas to deliver the visit using Health Risk Assessment (HRA) guidelines using an automated process.

2. Providers are not able to make paradigm shift. There are many providers that believe patients may suffer if they provide exam rooms and time for wellness and prevention. Fact is wellness visits can be performed in less than 30 minutes by a licensed medical professional that is part of the physician’s team. Treating "sick" patients and ignoring wellness is not the answer to provide quality healthcare. Providers must make a paradigm shift and practice more proactive healthcare using readily available and easy to use technology.

3. There is no convincing evidence that preventive services will provide quality and decrease costs in the Medicare population. The Annual Wellness Visit is not just about providing preventive services. It also encourages individuals to take an active role in accurately assessing and managing their health, and consequently improve their quality of life. Thus, a main purpose of the AWV is achieved by collecting information relevant to effective patient engagement and providing feedback that is welcomed and actionable. An HRA involves collecting and analyzing health-related data to evaluate the health status or health risk of an individual.

4. The AWV does not integrate with a practice EHR. Most EHRs provide templates for delivering the AWV. Some providers choose to use paper forms purchased on the Internet or designed in house. These options do not ensure providing all the necessary components of the visit such as a Personalized Prevention Plan (PPP) and Testing & Screening Schedule. There are automated solutions that guarantee compliance with all CMS-required components a PPP.

In addition, valuable data can be collected to make business and clinical decisions real-time. Providers must make a paradigm shift and acknowledge the importance of wellness and prevention in their practices. For more information about these automated solutions, feel free to contact the author, George Marmo, at gmconsultingllc@gmail.com.