The American Academy of Family Physicians defines the Annual Wellness Visit (AWV) as an opportunity to gain information about a patient, including medical and family history, health risks, and specific vitals. Its purpose is to review the patient’s wellness and develop a personalized prevention plan, not to serve as a head-to-toe physical examination.
AWVs must usually meet several criteria and the clinician’s documentation must support them. Below is a description of some of the items Medicare requires providers to address during an AWV. For a complete list, click here.
- Health risk assessment that includes evaluation of and appropriate referrals for assistance with:
- psychosocial risks, which includes areas such as life satisfaction, loneliness/social isolation and pain;
- behavioral risks related to tobacco use, physical activity, nutrition, alcohol consumption and others;
- activities of daily living (ADLs) like dressing, feeding, toileting and grooming, as well as instrumental ADLs, which encompass using the phone, housekeeping, managing medications, and handling finances; and
- risk for depression, falls and safety.
- Documentation of health measures, such as body mass index, blood pressure and other factors relevant to the patient’s health history.
- Past medical and surgical history as well as the providers and suppliers involved in the patient’s medical care.
- List of recommended health screenings for the next five to 10 years.
- A discussion of advance care planning, which considers the patient’s preferences for future care decisions in the event of illness or injury, identification of caregivers and explanation of any advance directive.
- Review of current opioid prescriptions, discussion of alternative non-opioid treatments and a screening for potential substance use disorders.
Payors also have guidelines regarding the timing of AWVs. Medicare, for example, covers the AWV once every 366 days, while some commercial payors just require that it be performed annually.
AWVs are encouraged or required by virtually all payors, and result in higher payment than an office visit. Some insurers incentivize providers and/or members to have AWVs and in the case of Medicare beneficiaries, AWVs are also important for attribution of ACO members.