An annual planned visit (APV) can be a significant driver of positive health outcomes and engagement with a patient’s provider. There are three main types of important, but often underutilized, APVs: initial preventive physical exam (IPPE), annual wellness visit (AWV), and annual routine physical (ARP). By engaging your patient early in the year to schedule these visits, there is opportunity to increase your APVs in 2023, and, in turn, improve the health of your patients and increase your success in the value-based programs (VBPs) you may participate in.

The AWV is an important opportunity to address up to 20 Medicare Advantage Stars measures that encompass both clinical quality and patient experience. The development of a personalized prevention plan is a required component of the AWV and can be a useful tool in leading these conversations with patients.

 

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The terms AWV and ARP are often incorrectly used interchangeably, which can cause confusion as these services are vastly different. AWVs are visits that are focused on preventive care, screenings, and the development of a personalized prevention plan. While an AWV includes taking standard measurements such as blood pressure, height, and weight, no hands-on physical exam is performed. The ARP is more extensive than an AWV in that it consists of a comprehensive, multi-system physical exam and includes bloodwork and other lab tests that are all based on the patient’s age, gender, and identified risk factors.

Note: An AWV and ARP may be performed during the same visit and providers can submit one claim that includes codes for both.



While the AWV may seem to have many requirements, several components of this visit can be performed by care team members other than the provider. See the sample workflow below that highlights steps that office staff can complete.



It is essential for providers to complete an APV for each of their assigned Medicare members. These visits help keep patients healthy and can increase practice revenue. For more tools and resources, please visit https://www.anthem.com/provider/medicare-advantage/ or reach out to your provider representative.


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Featured In:
March 2023 Anthem Provider News - Nevada