Key Takeaways

  • Medicare’s free Welcome to Medicare and Annual Wellness Visits are preventive services aimed at addressing a range of health concerns such as depression, cognitive impairment, and fall risk.

  • Introduced in 2011 as part of the Affordable Care Act, the Medicare Annual Wellness Visit has not realized its full potential to address the preventive health care needs of older adults.

  • The Aging Network could provide a range of services to improve the Medicare Annual Wellness Visit, including Medicare beneficiary awareness and education, receiving referrals from local health care providers, and providing supportive services for needs identified through the visits.

Providing preventive health care to older adults is more critical now than ever, considering the impact of the pandemic on older adults and those with chronic illness and/or physical disabilities. And the Annual Wellness Visit (AWV) benefit through Medicare is an important but under-used component of preventive health for Medicare beneficiaries.

The Aging Network can play a vital role to address barriers to AWV access, especially for minority and underserved older adults.

What are Medicare Annual Wellness Visits?

Introduced as part of the Affordable Care Act, Medicare AWVs are designed to provide health promotion and preventive care to Medicare beneficiaries and are an important strategy in addressing a range of issues that significantly impact quality of life such as such as depression, cognitive impairment, and fall risk. Yet Medicare AWV policy and inherent limitations have meant this benefit has failed to realize its potential and address the preventive health needs of older adults.

The reality of incorporating those wellness visits into clinical practice poses challenges for health care providers, given the time constraints and other pressing health concerns for older patients.

How can the Aging Network improve use of the Annual Wellness Visit?

Area agencies on aging, community-based organizations, and others in the Aging Network are well-poised to expand access to and use of the AWV. The network can:

  • Deliver education and awareness
  • Provide supportive services
  • Conduct all or part of the health risk assessment
  • Accept referrals for social services that address unmet needs. Community-based organizations  can also provide follow-up for needed services from health care providers conducting the AWV.

Developed in partnership with the USAging’s Aging and Disability Business Institute through a grant from the John A. Hartford Foundation, "The Annual Wellness Visit: Opportunities for the Aging Network" policy spotlight describes Medicare’s Wellness Visits, current approaches to provide this benefit to Medicare beneficiaries, challenges related to access and opportunities for the Aging Network. This brief also presents policy and programmatic recommendations to improve uptake and effectiveness of wellness visits and an enhanced role for the Aging Network.

What other changes could expand access to the Medicare Annual Wellness Visit?

As policymakers consider improvements to Medicare, an expanded role for the Aging Network related to the AWV should be part of the conversation. NCOA also recommends several policy and regulatory changes to reduce barriers to AWV access, including:

  • Allowing the Annual Wellness Visit to be conducted without direct physician oversight
  • Extending telehealth benefits under Medicare
  • Incorporating a screening for the social determinants of health (SDOH) in the Annual Wellness Visit and including a modest bonus payment or increased reimbursement to providers who conduct the SDOH screening
  • Strengthening standards and requirements fo rscreenings and referral protocols for home and community-based services such as nutrition, evidence-based health promotion and disease prevention programs, and transportation
  • Collecting data and conducting oversight to track and better ensure compliance with statutory requirements that health risk assessments meet hte guidelines established by the secretary of health and human services
  • Supporting an evaluation conducted by the Centers for Medicare and Medicaid Services (CMS) Innovation Center, or another entity, of current practices and how to improve access to and effectiveness of the Medicare Annual Wellness Visit

NCOA will continue to advocate for needed changes to the AWV to reduce barriers to access and for increased opportunities for the Aging Network to partner with health care providers through contracts and reimbursement for services related to the AWV.