Please note: Out of an abundance of caution and concern for our patients’ health, we will not be scheduling any ACO Initial Preventive Physical Exams or Annual Wellness Visits until June 15, 2020.
Accountable Care Organization Annual Wellness Visit (AWV)
As a Medicare fee-for-service beneficiary, you may be entitled to two very important benefits that can impact your health and quality of life.
- Initial Preventive Physical Exam, or IPPE. This is often referred to as your “Welcome to Medicare” visit. The IPPE is a once per lifetime benefit that is only available during your first 12 months of coverage under Medicare Part B.
- Annual Wellness Visit, or AWV. The AWV is an annual benefit that becomes available after you’ve been covered 12 months under Medicare Part B, and can be used every 12 months thereafter.
The purpose of these benefits is to give you and your doctor the opportunity to discuss your current health and to develop a personalized plan of wellness and prevention—just for you!
If you haven’t done so, make sure to take advantage of these benefits by scheduling an appointment with your Graybill healthcare practitioner.
The IPPE and AWV are NOT the same as a Routine Physical Exam
Although the IPPE and AWV have been available since 2010, as part of the Affordable Care Act, most people still don’t take advantage of them. Perhaps it’s because they’re easily confused with a Routine Physical Exam.
In fact, the IPPE, AWV, and Routine Physical Exam are separate and distinct exams:
- Except for a few basic measurements (height, weight, blood pressure, heart rate, and Body Mass Index), the IPPE and AWV do not include a hands-on physical examination.
- The IPPE and AWV are focused on health promotion, disease prevention, and early detection. They are 100% covered by Medicare and are available at no cost to you. (Be aware that if your healthcare provider orders additional lab tests or services that are not part of the IPPE/AWV, you may be responsible for some or all of the costs of those tests or services.)
- Routine Physicals are NOT covered by Medicare; you must pay 100% of the cost.
IPPE, AWV, AND ROUTINE PHYSICAL EXAMINATION – KNOW THE DIFFERENCE
|Initial Preventive Physical Examination (IPPE)||Annual Wellness Visit (AWV)||Routine Physical Examination|
|Purpose||Review of medical and social health history, and preventive services education||Develop or update a personalized prevention plan, and assess health risks||Exam performed without relationship to treatment for a specific illness, symptom, complaint, or injury|
|When is it covered||Covered only once per lifetime and within 12 months of enrollment in Medicare Part B||Covered after 12 months of enrollment in Medicare Part B; thereafter, available once every 12 months||Not covered by Medicare|
|How much does it cost?*||$0*||$0*||You pay 100% of the cost|
What happens during an Initial Preventive Physical Exam (IPPE)?
During the IPPE, your healthcare provider will:
- Review your medical and social history (such as medications and supplements you are taking, past illnesses, hospital stays, operations, allergies, injuries and treatments; alcohol and tobacco use; diet and physical activities)
- Review your potential risk factors for depression and other mood disorders
- Review your functional ability and level of safety; including activities of daily living, fall risk, hearing impairment, and home safety
- Measure your height, weight, body mass index and conduct a basic eye test.
- Optional (at your discretion): discuss end-of-life planning
- Based on items 1-5, educate, counsel, and refer you to additional resources.
- Educate, counsel, and refer you for other preventive services as appropriate
What happens during an Annual Wellness Visit (AWV)?
During an AWV, your healthcare provider will:
- Perform a health risk assessment (including demographic data, a self-assessment of your current health status, psychosocial and behavioral risks, ability to conduct activities of daily living and other activities)
- Establish your and your family’s medical history (including current medications and supplements, past illnesses, surgeries, hospital stays, operations, allergies, injuries, and treatments)
- Establish a list of healthcare providers and suppliers who regularly provide your medical care
- Measure your height, weight, body mass index or waist circumference, and blood pressure, and other routine measurements based on your medical and health history
- Examine you for any signs of cognitive impairment
- Review your potential risk factors for depression, including past experiences with depression or other mood disorders
- Review your functional ability (ability to perform basic activities of daily living) and level of safety (risk of falls, hearing impairment, home safety)
- Establish a written schedule of health screenings for the next 5 to 10 years
- Establish a list of risk factors and conditions which may require treatment options or interventions
- Provide you with a list of personalized health advice and referrals to health education or preventive counseling services, such as fall prevention, nutrition, physical activity, tobacco-use cessation, weight loss, and cognition
- Optional (at your discretion): introduce advanced care planning, such as the use of caregivers, advanced directives.
During subsequent Annual Wellness Visits, you and your healthcare provider will meet again to review and if necessary, update the above items.
How to have a successful Annual Wellness Visit
To make the most out of your annual wellness visit:
- Bring a list of medications and supplements that you are taking.
- Write down anything that is bothering you, including any changes you’ve noticed in your health over the last 12 months. This might include changes in memory, vision, hearing, emotional state, etc.
- Have an idea of your healthcare goals, such as achieving a healthy weight, improving the safety in your home, or becoming socially active.
- Give thought to any advanced care wishes, such as whom you might appoint as a healthcare proxy, or whether you want to stay at home versus an assisted living facility.
For more information, see AARP: 10 Things to Know About AWVs