The Medicare Annual Wellness Visit (AWV) is a valuable opportunity for primary care practices to engage patients, improve care quality, and support practice goals. Unlike a standard annual physical, the AWV is designed for a focused conversation with patients to review their health status, medications, and preventive needs, while planning for future care.
Why Encourage AWVs in Your Practice?
- Enhance Care Coordination:
The AWV provides a dedicated time to reconcile medications, order essential screenings and vaccinations, and discuss whole-person and preventive care. This visit encourages patients to take an active role in their health, fostering stronger provider-patient relationships.
- Support Quality Metrics (HEDIS, STAR, Withold):
Properly coded AWVs help capture and document required quality measures for Medicare duals plans, including STAR and Withold metrics. Utilizing CPT II codes ensures accurate claims-based reporting and helps confirm that we are in receipt of accurate documentation of care gap closure.
- Improve Hierarchical Condition Category (HCC) Risk Scores:
AWVs support accurate diagnosis documentation, which is critical for HCC risk adjustment. Accurate HCC coding ensures appropriate risk scores, which are used by the Centers for Medicare & Medicaid Services (CMS) to determine risk-adjusted payment rates.
- Boost Patient Experience and Retention:
AWVs allow providers to spend meaningful time with patients, strengthening communication and trust. These visits create opportunities to identify needs for follow-up and preventive care, supporting ongoing patient engagement.
To encourage participation, CCA offers its members a $25 reward for completing their Annual Wellness Visit. This incentive is added to a Healthy Savings card or provided as a gift card from a selection of partnered retailers after the AWV claim is processed. The reward can be used at participating Healthy Savings retailers, with the exception of firearms, tobacco, alcohol, or gift cards.
Action Steps for Providers:
- Schedule AWVs annually for eligible patients.
- Use appropriate CPT II codes to ensure accurate documentation.
- Educate patients about the benefits of the AWV.
By prioritizing the AWV, your practice can improve patient outcomes, meet quality requirements, and strengthen patient relationships.