American College of Physicians: Internal Medicine — Doctors for Adults ®

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New tool for Annual Wellness Visits

From the May ACP Internist, copyright © 2012 by the American College of Physicians

Practice owners may question whether Medicare's Annual Wellness Visit is worth the effort. The answer is yes. For Medicare patients who want to take advantage of this service, and for physicians who do preventive care anyway, a well-planned and orchestrated Annual Wellness Visit can actually be a winning proposition.

However, last year, the Affordable Care Act added a new required element to the Annual Wellness Visit, the Health Risk Assessment. This self-reported assessment is completed before the clinical encounter and as a supplement to data collected by other means during the Annual Wellness Visit itself. It is also intended to be a planning tool, just like physical examinations, labs, and clinical preventive screening results. The goal of both the Annual Wellness Visit and the Health Risk Assessment is to improve health behaviors and/or reduce the patient's risk of disease or injury.

The Health Risk Assessment adds a new but not insurmountable layer of effort and time to the visit. Practices that have already incorporated the Annual Wellness Visit will find that adding the assessment is fairly easy.

The assessment must include questions about all required areas and should take no more than 20 minutes to complete. Each topic area should be “actionable” in that if the responses identify a risk, the clinician should be able to treat, counsel or refer the patient, through shared decision making, to an appropriate treatment or risk mitigation program.

During the Annual Wellness Visit, the clinician uses the information gleaned from the Health Risk Assessment (and any other screening devices) to identify any previously undocumented chronic diseases, urgent health needs, or behavioral or injury risks and to provide feedback to the patient in the form of education, counseling, or referral.

With all this information in hand, the physician can give the patient a personalized preventive plan. This is a simple form telling the patient what he or she should do next. Then the patient can schedule subsequent visits before or after taking care of some of the actions recommended in the prevention plan.

The practice may use the Health Risk Assessment and the Men's and Women's Preventive Plans to refer patients for further evaluation and treatment. These can be downloaded for free. Practices using an electronic health record and/or a personal health record can use a Web-based version. A Web-based Health Risk Assessment (created by HowsYourHealth.com) can be found online.

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