Your Questions Answered: What Older Adults Should Know About Medicare Annual Wellness Visits

As a geriatrician, I regularly conduct Medicare Annual Wellness Visits and have received many questions about what they involve and how they differ from other types of appointments. Here, I’ll address some of the common questions I hear and explain how the “4Ms” of age-friendly health care — medication, mobility, mind, and what matters most — play an important role in these visits. Let’s dive in.   

What is the Medicare Annual Wellness Visit?

Medicare created the Annual Wellness Visit in 2011 as part of the Affordable Care Act. It was designed to encourage preventive care health maintenance rather than simply treating problems that have already arisen.

My previous doctor used to have me come in for a yearly physical. How is the Annual Wellness Visit different?

The Annual Wellness Visit includes screening services and health assessments, such as asking about falls and checking your balance, carefully reviewing medications, updating immunizations, and more. The traditional head-to-toe physical examination is no longer a covered benefit, as evidence is lacking that this makes a significant difference in overall health. Traditional examinations often overlook the most essential aspects of your health, namely the 4Ms of age-friendly health care.    

What are the 4Ms?

Medication: Evaluating the medicines you are taking is critically important. Are they working as intended? Is the dosage appropriate? Are there adverse effects or drug interactions to watch for? Do some of your drugs actually counteract others you take? Are they affordable? Can any be eliminated, or are there other treatments that could work better?

Mobility: Falls and injuries are among the most common causes of disability and death for older adults. Addressing the risk factors and preventive strategies before a fall and serious injury occurs is the goal of the Annual Wellness Visit. Your health care team may watch you get up from a chair and time your walking speed. Your visit may also include an assessment of your bone health. If you use a cane or walker, please bring that device to the Annual Wellness Visit or any other visit where it is important to observe your ability to move around.

Mind: Do you or those who know you well have concerns about your memory and cognitive function? How is your mood? These questions are asked and explored at the Annual Wellness Visit. Additional time and visits may be needed to fully address concerns that are raised.

What Matters Most: This is probably the question health care professionals have been the least likely to have asked you in the past. But it’s well worth pondering before your visit. What are your most important health care goals, and how do they fit in with overall life goals? Do your health issues get in the way of doing what matters most? Whenever possible, our treatment plans should be designed to foster your goals and not hinder them. 

What if I have additional concerns to bring up during my visit?

The fifth M is More. The Annual Wellness Visit is a longer visit, but there’s lots to cover! If time permits, new issues or concerns with prior health issues can be addressed, but if they’re not urgent, they may require a follow-up visit to have adequate time to examine them fully. Of course, if what matters most is an urgent medical issue, then that will become the focus of the visit, with the Annual Wellness Visit being postponed to a later date if insufficient time remains.

How should I prepare for my Annual Wellness Visit?

Bring an up-to-date list of all medications, prescribed and over-the-counter. If you have any uncertainties or if your list of drugs is complex, consider bringing all the bottles, a weekly pill box, or pill pack cards to allow your health care team to verify that everyone is working from the same list.

Bring your important health documents, including a copy of your Health Care Proxy, any other advance directives, and a list of all the health care providers you are seeing. It’s a good idea to create a file containing these important documents and others, such as medication lists and health conditions, to keep handy for appointments or in case of a medical emergency. 

Prioritize the items you hope to cover at the visit and see if you can fit them into the 4Ms framework of Medications, Mobility, Mind, and What Matters Most.

Our commitment to age-friendly health care

Hebrew SeniorLife’s commitment to evidence-based, person-centered care is why Hebrew Rehabilitation Center in Boston and Hebrew Rehabilitation Center at NewBridge on the Charles in Dedham, MA, are designated Age-Friendly Health Systems by the Institute for Healthcare Improvement. In addition, our Hebrew SeniorLife outpatient clinics at NewBridge on the Charles in Dedham, MA, and Orchard Cove in Canton, MA, are also participants in this program.

That dedication shines through in services ranging from long-term chronic care, post-acute rehabilitative care, outpatient memory care at the Deanna and Sidney Wolk Center for Memory Health, a comprehensive range of outpatient care clinics, and more.

Interested in discovering what age-friendly care could look like for you? Find a service or community online today to learn more.  

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