From the Research
You should change the visit from an annual wellness exam to a problem-focused visit if the patient has chief complaints that require evaluation and management. This approach is supported by the most recent study from 2024, which highlights the importance of addressing specific health concerns in a timely manner, as seen in the RN-led model of care pilot study [ 1 ]. Start by explaining to the patient that you'll need to address their specific health concerns first, and reschedule the annual wellness exam for another time. This ensures proper focus on and billing for the acute issues. Document the change in visit type in the medical record, noting the reason for the switch. Proceed to evaluate and manage the patient's chief complaints as you would in a regular office visit.
Key Considerations
- After addressing the immediate concerns, you can still perform some elements of preventive care if time allows, but the visit should primarily focus on the presenting problems.
- This approach allows for appropriate care delivery and accurate billing, as supported by the study on patient satisfaction with Medicare Annual Wellness Visits administered by a clinical pharmacist practitioner [ 2 ].
- It also helps maintain the distinct purposes of wellness exams (preventive care) and problem-focused visits (addressing specific health issues), as discussed in the article on the Medicare Annual Wellness Visit [ 3 ].
Additional Insights
- The study on age-friendly health care and the 4Ms in RN-led annual wellness visits [ 4 ] provides further evidence for the importance of addressing patient-specific concerns and promoting health maintenance, which can be achieved by changing the visit type when necessary.
- The study on outcomes of annual wellness visits provided by pharmacists in an accountable care organization [ 5 ] also highlights the value of addressing patient-specific concerns and promoting health maintenance, which can be achieved by changing the visit type when necessary.