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Getting Necessary Care, Quickly

by

DUOS

3.1.23

Today there are 31.5M individuals enrolled in a Medicare Advantage plan. Medicare Advantage Organizations (MAOs) rely on the Annual Wellness Visit (AWV) both as a critical preventative care management strategy and as foundational for appropriate risk adjustment, resulting in the allocation of significant resources to encourage members to complete AWVs. Data and experience show that the results of these efforts are quite mixed, at best, and that MAOs often invest resources in a final “sprint” to improve results in the fourth quarter. However, many members still do not complete their AWV.

Why do members not complete their AWVs despite costly plan efforts? What can plans do to address this major business and health issue? A deeper dive into the root cause of poor patient adherence shows that social barriers (e.g. transportation) are a critical root cause.

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