Adoption and Value of the Medicare Annual Wellness Visit: A Mixed-Methods Study

Medicare's Annual Wellness Visit (AWV) was introduced in 2011 to encourage the utilization of preventive services, but many clinicians and patients still do not participate in the visit. We qualitatively and quantitatively assessed motivations and clinical and financial value of AWVs from a primary care perspective using interviews and Medicare claims from 2012 to 2019. Primary care providers with the highest acuity patients had AWV utilization rates 11.2 percentage points lower than providers with the lowest acuity patients; utilization rates were 3.8 percentage points lower in rural counties. Adoption was motivated by patient needs and financial incentives. AWVs closed gaps in preventive care, strengthened patient-provider relationships, facilitated advance care planning, and provided an opportunity to improve quality metrics. Overall, the AWV has the potential to increase the use of high-value preventive services although not all clinics have an economic incentive to adopt the visit, which may explain some of the variability in utilization rates.

Automated summary

The Medicare's Annual Wellness Visit (AWV) was introduced in 2011 to promote preventive services utilization, but there is still a lack of participation from clinicians and patients. Through interviews and Medicare claims data from 2012 to 2019, we qualitatively and quantitatively assessed the motivations and clinical and financial value of AWVs from a primary care perspective. The utilization rates of AWVs were lower for primary care providers with higher acuity patients and in rural counties. Adoption of AWVs was driven by patient needs and financial incentives. AWVs closed gaps in preventive care, improved patient-provider relationships, facilitated advance care planning, and provided an opportunity to enhance quality metrics. Overall, AWVs have the potential to increase the use of high-value preventive services, although economic incentives may explain the variability in utilization rates among clinics.