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In many accountable care organizations (ACOs), frontline physicians are under strong pressure to schedule Medicare annual wellness visits (AWVs) for every eligible patient. On paper, AWVs are framed as a cornerstone of value‑based care. In reality, for patients who already receive regular, well‑designed chronic care and follow‑up visits, a separate AWV can easily become cost‑ineffective. It adds encounters and expense without a clear marginal benefit, and it consumes scarce access that might otherwise prevent emergency room visits and hospitalizations.
What AWVs do (and what they don’t do)
Medicare defines the AWV as a structured preventive planning visit. It centers on the following:
- A health risk assessment
- Review and update of medical, surgical and family history
- Review and update of medication and problem lists
- Screening for depression, cognitive issues and functional risk
- A personalized prevention plan and screening schedule
An AWV does not require a comprehensive head‑to‑toe physical examination, and it does not automatically include labs or imaging. Those are ordered separately when clinically indicated, just as they would be during a routine follow‑up visit. In other words, the value of an AWV lies almost entirely in its cognitive and planning work, not in ritualized annual physical testing.