Assignment: NP Role in the Medicare Annual Wellness Assessment

Assignment: NP Role in the Medicare Annual Wellness Assessment

Assignment: NP Role in the Medicare Annual Wellness Assessment

Medicare Annual Wellness Visits (AWV) allow healthcare professionals to obtain information about a patient, including their medical and family history, health risks, and particular vitals. The AWV is performed to review a patient’s wellness and create an individualized prevention plan (Loskutova et al., 2022). Besides, the services provided during the AWV vary from the typical preventive care visit and usually include physical, emotional, and psychological wellbeing. The NP should take the opportunity provided by AWV to improve the quality of care provided to older adults in the primary care setting as well as assist them in patient engagement, and optimize payment opportunities.

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With regard to the scope of practice, the NP has various roles in AVW for elderly persons, including:  Reviewing patients’ medical and social history; Reviewing patient’s risk factors for depression, including their current and past experiences with depression and other mood disorders; Evaluate patients’ functional ability and safety level; Conduct physical exam; Assess current opioid prescriptions (Loskutova et al., 2022). The NP should develop a list of current physicians and primary care providers frequently involved in the medical care of the older adult. In addition, the NP should obtain blood pressure, weight, height, body mass index, waist circumference, and other measurements as considered appropriate.

The NP should help elderly patients in primary care settings with end-of-life planning with their consent. The NP should provide older adults with verbal or written information to empower them to prepare an advance directive if they encounter an illness or injury that hinders them from making healthcare decisions. Based on the patient review and assessment results in the above components, the NP is tasked with providing appropriate patient education, counseling, and referrals (Beckman et al., 2019). Furthermore, the NP should educate, counsel, and refer older adults to preventive services. The NP should create a written screening schedule for the older adult, like a checklist for the next 5-10 years, based on appropriate screening recommendations such as having a once-in-a-lifetime electrocardiogram.  Regarding Medicare billing regulations, the NP has the role of using HCPCS codes to file AWV claims. The codes include G0438 for AWV initial visits, G0439 for subsequent visits, and G0468 for Federally qualified health center visits (Sitapara, 2018). In addition, the NP is tasked with reporting a diagnosis code when submitting AWV claims and should choose any diagnosis code coherent with the patient’s exam.

When conducting AWV for elderly persons, the NP should conduct a risk assessment by administering a Health Risk Assessment (HRA). The HRA includes demographic data, psychosocial and behavioral risks, health status self-assessment, and daily living activities (Sitapara, 2018). Older adults are at high risk for cognitive decline. Thus, the NP should assess a patient’s cognitive function. Furthermore, the NP should screen older adults for potential substance use disorders (SUDs) and can achieve this using screening and assessment tools. The NP should assess a patient’s potential SUD risk factors and appropriately refer them for treatment. Additionally, the NP should apply the best practices for screening during AWV for older adults in the primary care setting. For example, the NP can leverage patients’ data and report so that one can know the older adult who is due, or overdue, for their AWV (Beckman et al., 2019). Besides, the NP can prioritize older adults for their AWV based on their medical complexity or those who have not attended an AWV for more than a year.

References

Beckman, A. L., Becerra, A. Z., Marcus, A., DuBard, C. A., Lynch, K., Maxson, E., … & King, J. (2019). Medicare Annual Wellness Visit association with healthcare quality and costs. Am J Manag Care, 25(3), e76-e82.

Loskutova, N. Y., Callen, E. F., & Westfall, J. M. (2022). Standardized patient assessments at the Medicare annual wellness visit: results from the AAFP National Research Network. The Journal of the American Board of Family Medicine, 35(3), 605-609. https://doi.org/10.3122/jabfm.2022.03.210345

Sitapara, A. (2018). Medicare annual wellness visit health risk assessment. Family practice management, 19(5), 10.