A Virtual Practice-Tailored Medicare Annual Wellness Visit Intervention: Increasing Use and Preventive Health Care

Introduction: Interventions are needed to promote utilization of the Medicare Annual Wellness Visit (AWV), an underused opportunity to perform screenings and plan individualized preventive health services. Methods: Using remote practice redesign and electronic medical record support, we implemented the Practice-Tailored AWV intervention in 2021 (during the COVID-19 pandemic) in 3 small community-based practices. The intervention combines electronic health record (EHR)-based tools with practice redesign approaches and resources. Outcomes included completion of AWV and fulfillment of recommended preventive services. Results: At baseline the 3 practices had 1513 Medicare patients with at least one visit in the past 12 months. AWV utilization went from 7% at baseline to 54% eight months post-intervention implementation; advance care planning increased 10.7% (from 7.9% to 18.6%); depression screening increased 16.3% (from 51.7% to 68.0%); and alcohol misuse screening increased 17.3% (from 42.6% to 59.9%). Every individual preventive health service was received more often by patients with an AWV than those without. At the patient level, fulfillment of all eligible preventive services (of a maximum of 12 evaluated) went from 47.5% to 53.8% (p<0.001). Subgroup analyses showed that patients with AWVs completed a greater percentage of their total recommended preventive health services than those without an AWV. Conclusion: Virtual implementation of an intervention that combined EHR-based tools with practice redesign approaches increased AWV and preventive services utilization in Medicare patients. Given the success of this intervention during the COVID-19 pandemic (when practices had many competing demands), greater consideration should be given to delivering future interventions virtually.