Medicare Patients Offered More Comprehensive Care at Annual Wellness VisitLast updated: Jan 30, 2017
Have you been taking advantage of Medicare’s free Annual Wellness Visit (AWV)? For the past five years, Summit Medical Group (SMG) has offered this no-cost visit to seniors, which helps identify risk factors for disease and develop a plan for continued wellness.
Your AWV is key to prevention. But it is often incomplete for patients over 65 because it does not include a physical exam or address active medical problems.
In an effort to provide more comprehensive care, SMG providers ensure that all your medical issues are addressed at the time of your AWV. We call this a Comprehensive Care Visit (CCV). A CCV is similar to a traditional physical with your primary care physician because it diagnoses and treats medical problems such as arthritis, back pain, diabetes or high blood pressure.
“Nearly all of our Medicare patients have either chronic conditions or complaints that can be and should be managed at the time as the AWV with their primary care physician,” says Ashish D. Parikh, MD, an internal medicine physician and senior medical director for quality and utilization Management at Summit Medical Group.
“For example, if you are having difficulty sleeping or experiencing back pain, Medicare does not cover this as part of your AWV. However, we believe that good care is comprehensive care. So our providers will perform a physical exam and help address your concerns at the same time as your AWV before you leave the building.”
Medicare covers the AWV without any out-of- pocket cost. But what does the visit include?
- Review of medical, surgical, and family history
- Measurement of height, weight, and blood pressure
- Assessments for depression, risk of falls, and memory problems
- Review your prescriptions and over-the-counter drugs for possible interactions
- Recommendations for immunizations, such as the flu or pneumovax shots, and health screenings, such as colonoscopy or mammogram
- A written preventative plan is provided at the end of the visit that outlines next steps for continued wellness
Even though Medicare does not cover a physical exam, you can still get comprehensive care. The AWV is limited to preventive services. However, Medicare does allow your doctor to address other issues during the same visit with a CCV. When a CCV is added to the AWV, you are only responsible for a copayment or coinsurance similar to any other visit to the doctor. You also receive more comprehensive care including:
- All preventive services PLUS
- A physical exam
- Management of acute and/or chronic conditions including back pain, allergies, difficulty sleeping, mental health concerns, diabetes, high blood pressure, arthritis, or heart palpitations
- Referrals for laboratory or imaging tests as needed
- Follow-up with a specialty physician if required
“Preventative medicine saves lives,” says Dr. Parikh. “Even if you are in generally good health for someone over 65, you may not realize that your blood pressure is high, a medication has an interaction, or you are overdue for an eye exam. It is important to take a step back each year and schedule your AWV.”
If you have an acute concern or chronic condition, Dr. Parikh urges Medicare patients to schedule the CCV as well. Only half of patients—who have two or more chronic conditions—are seen more than once each year by their PCP.
Primary Care Physicians are Key to Better Overall Health
PCPs are the cornerstone of patient care, particularly in adults over 65. Research shows that people who have an ongoing relationship with a PCP, and get the recommended preventative screenings and immunizations, have better overall health and lower rates of mortality. If you do not have a primary care provider, SMG will find one for you.
What is Coordinated Care Reward?
Some of you who have Medicare may have received a letter notifying you that Summit Medical Group is part of the Trinity Health Accountable Care Organization (THACO). Rest assured that this does not change your Medicare coverage in any way. What it does mean is that Summit Medical Group is committed to delivering high-quality coordinated and comprehensive care.
Medicare is offering a $25 reward to patients covered under Trinity Health who receive their AWV. SMG is not reimbursing patients. This payment will come from Medicare. So schedule your AWV today.
1. Interview with Ashish D. Parikh, MD, Senior Medical Director for Quality and Utilization Management at Summit Medical Group (1/16/17).