Registered Nurse-Led Annual Wellness Visits

Registered nurse (RN)-led annual wellness visits (AWV) offer Medicare patients an opportunity to collaborate with a member of their care team to evaluate preventative care gaps at no cost to them. By completing these visits yearly, care gaps can be closed, and preventive services can be offered to these most vulnerable patients, thus maximizing their health and decreasing their healthcare costs. According to Farford, et al. (2020), “The RN-led AWV is an effective way to assist Medicare beneficiaries in meeting their preventive needs while allowing physicians more time to focus on chronic and acute needs.” However, despite valuing the AWV and understanding the components for documentation, the rate of non-billable visits to Medicare was 57% in January of 2023. There were old templates in Epic that did not prompt the RN to enter all the required information for a visit to be considered billable to Medicare. This gap in documentation was discovered at the same time nursing was being asked to increase the number of AWV from 5% to 24% across primary care. Nursing leaders collaborated to create an AWV express lane in Epic and deleted old, non-compliant templates. Informational sessions were held to discuss AWV billing requirements and the importance of AVWs and to provide education to introduce the express lane. Post-implementation measures showed intervention success with AWV non-billable visits decreasing from 57% to 17%. Future efforts to enhance AWVs include increasing nurse staffing levels to allow additional visits to be completed, educating patients and the public regarding the importance of the AWVs, enhancing motivational interviewing skills for the RN, and ensuring we remain up to date on changes to Medicare requirements.