Primary care practices that performed Medicare wellness visits had higher revenue study shows

Primary care practices that performed Medicare wellness visits had higher revenue study shows March 14, 2018

The annual wellness visit was introduced by Medicare in 2011, as part of the Affordable Care Act (ACA). Wellness visits are intended to enable the primary care physician to screen elderly patients for potential risks for conditions that affect that particular population group. For the patient, the wellness visit is conducted free of charge. If the physician does find an issue that needs to be addressed, however, the visit shifts to the category of a problem-based visit.

A recent study showed that “uptake of the visit has been uneven.” The study found that in 2015, “51.2 percent of practices provided no annual wellness visits (nonadopters), while 23.1 percent provided visits to at least a quarter of their eligible beneficiaries (adopters).” As a result of adopting the wellness visit concept and replacing the strictly problem-based visits with an annual wellness visit for their Medicare patients, primary care physicians realized an increase in their revenue.

One benefit of the wellness visits for both patient and physician, discovered in the study, was that the adopting primary care practices “saw a slower increase in average risk, with an increase of 0.02 in risk scores versus 0.04 among non-adopters.” This factor also contributed to the increased revenue for the adopting primary care practices, as higher risk patients are more expensive to treat.

One significant indicator of the rate of wellness visit adoption was the primary care physician’s EHR capability. Those practices that used EHRs were “more likely to provide wellness visits than other practices, with 26 percent of practices with at least 50 percent participation in the Medicare EHR Incentive program versus 15 percent of practices with lower participation.”

In regard to the low rate of wellness visit adoption by primary care physicians, the researchers conducting the study stated that “While it is unclear whether these changes were driven by the adoption itself or by other changes implemented by adopters during the same period, it does point to some benefits for practices that adopt the visit.”