With our population aging and approximately 10,000 members of the Baby Boomer generation turning 65 every day, it has never been more important for healthcare providers to assess health risks and promote good preventive care among seniors. Putting the focus on prevention—rather than waiting to intervene with treatment until after a problem arises—greatly increases the odds of identifying chronic ailments or other health issues at their earliest, most treatable stages or stopping them in their tracks entirely. For this purpose, Medicare offers a free annual wellness visit to beneficiaries.
According to family physician Dee Bialecki-Haase, MD, vice president of operations for ProMedica Physician Group and president of ProMedica Health Network, the annual wellness visit is not the head-to-toe “physical” many people expect when they go to see their doctor on a yearly basis. Rather, it’s a review of preventive recommendations based on the patient’s age, health status, risk factors, and other considerations.
“The purpose of annual wellness visits is to ensure patients are getting all the Medicare-covered benefits they’re eligible to receive,” says Dr. Bialecki-Haase. “This includes, among other things, screening for colon cancer, breast cancer, depression, and dementia; verifying that they’re current on immunizations; assessing their functional status and fall risk; looking at factors such as obesity, alcohol consumption, and tobacco use to determine whether any lifestyle modifications are appropriate; as well as determining whether they have advance directives, such as a living will and durable power of attorney, in place.”
A very important aspect of the annual wellness visit is a health-risk assessment that the patient is asked to complete prior to the appointment. This questionnaire asks a series of questions related to health and function, such as whether the patient has experienced a fall, feels depressed or fatigued, is able to climb stairs, and needs help with household tasks. “One of the most significant questions on the survey is ‘How confident are you in your ability to manage your medical problem?’ If they answer that they’re not confident or only somewhat confident, we know they may be headed for trouble,” says Dr. Bialecki-Haase. Once completed, the assessment is reviewed by the clinician to help characterize the patient’s risk factors and need for resources.
Dr. Bialecki-Haase notes that Medicare annual wellness visits don’t necessarily have to be performed by a physician or nurse practitioner. Registered nurses, practical nurses, and other licensed clinicians can do them as well. “In fact, patients are sometimes more comfortable talking with a nurse about concerns that they think are too insignificant to discuss with a doctor, which helps us develop a more comprehensive picture of their health. And if the nurse identifies any areas of concern, an appointment with the doctor can be scheduled before he or she leaves the office, she says.
Dr. Bialecki-Haase also cautions that annual wellness visits are best conducted within the context of a medical practice, noting that many different organizations out there—including various screening companies that offer services such as carotid screenings and blood pressure checks at church gatherings and other community events—are now offering free wellness visits to the public. “The problem here is that Medicare approves only one free wellness visit per year. If you have it done by one of these companies instead of your primary care practitioner or medical care team, they won’t be able to give you a personalized preventive care plan when you leave because they don’t know anything about you or your medical history. All they’ll be able to provide is a generic listing,” she says.
Summing up the benefits of annual wellness visits, Dr. Bialecki-Haase states, “It’s a great opportunity to close any gaps in care—to ensure seniors are taking full advantage of all the appropriate Medicare-recommended preventive services available to them so they can continue to enjoy the highest possible quality of life.”❦