1. GERIATRIC EDUCATION SERIES Presented in partnership by Funded in part by a grant from the EJC Foundation

2. dhs.unr.edu/aging Geriatric Education Series MEDICARE ANNUAL WELLNESS VISIT Steven L. Phillips, MD Medical Director Sanford Center for Aging

3. Medicare Annual Wellness Visit Established in 2010 through the Affordable Care Act, this benefit was designed to encourage monitoring of physical and cognitive abilities, as well as development of plans associated with decreasing the impact of increasing frailty on everyday life for elders. Several of the chronic conditions experienced by elders are typically not of acute onset. These conditions often display minor symptoms at earlier stages that may be missed if not specifically screened for.

4. Course Objectives Objective 1: Describe the key elements of the Medicare Wellness Visit Objective 2: Provide criteria for prioritizing at risk patients in need of the Wellness Visit Objective 3: Define opportunities for closing gaps in care

5. Relevant Codes HCPCS/CPT Code: G0438 Completed once per beneficiary per lifetime HCPCS/CPT Code: G0439 Annual re-examination of the care plan previously established

6. Health Risk Assessment Key Elements Demographic data Self-Assessment of health Psychological risk and risk factors Behavioral risks Activities of Daily Living (ADLs) Instrumental Activities of Daily Living (IADLs) Assessment of medical history (including familial risk factors) Psychological screenings (depression, etc.) Frailty assessment/Functional Capacity Assessment of fall risk including home safety Cognitive assessment (direct observation and caregiver report) Advanced care preferences

7. Identifying at Risk Patients Living alone in community Increasing weakness Memory complaints Six or more chronic medications Involuntary weight loss Worsening mobility Five or more chronic conditions Three or more hospitalizations

8. Closing Gaps in Care Review chronic conditions Update immunizations Personalized care plan Highlight preventative services Medication reconciliation Identify in-home care needs Advanced directive/ POLST update Specialty referral as needed

9. Marketing to Clientele Stay healthy with free annual wellness visit Thorough review of medical and family history Developing or updating a list of current providers and medications Personalized health and wellness advice List of risk factors and educational options Discussion of additional screenings or services that may be beneficial to patient and family

10. Sanford Center Geriatric Specialty Clinic Steven L. Phillips, MD slphillips@unr.edu (775) 784-1808