title: Medicare annual wellness visits conducted by a pharmacist in an internal medicine clinic.
abstract: OBJECTIVE
  The clinical and financial outcomes of an initial Medicare annual wellness visit (AWV) administered by a clinical pharmacist practitioner (CPP) in an academic internal medicine clinic are described.
  
  
  CONCLUSIONS
  As a result of the Patient Protection and Affordable Care Act, Medicare Part B allows for coverage of an AWV at no cost to eligible beneficiaries. The AWV is directed at health prevention, disease detection, and coordination of screening available to beneficiaries. CPPs are pharmacists who are recognized as advanced practice providers in the state of North Carolina and are authorized to administer AWVs. Eligible Medicare beneficiaries at least 65 years of age in an academic internal medicine clinic were mailed invitations to schedule an AWV. Patients who scheduled an AWV were mailed a packet to complete before the visit. During the visit, the packet was reviewed and interventions were made based on prespecified criteria derived from evidence-based medicine recommendations. After completion of the AWV, patients were provided with a detailed and individualized prevention plan. Between August 2011 and May 2012, 98 patients attended an AWV, all performed by the same CPP. The average time from check in to checkout for all patients was 73 minutes. The CPP made 441 interventions during these 98 visits, averaging 4.5 interventions per AWV completed. All initial AWVs were reimbursable up to a maximum of $159.38 per visit.
  
  
  CONCLUSIONS
  A Medicare AMV administered by a CPP resulted in a wide variety of patient interventions and reimbursement for services provided.
authors.affiliation: LT Keith Warshany, Pharm.D., is Staff Pharmacist, Northern Navajo Medical Center, Indian Health Service, Shiprock, NM; when the project described in this article was undertaken, he was doctor of pharmacy candidate, University of North Carolina (UNC) Eshelman School of Pharmacy, UNC at Chapel Hill, Chapel Hill. Christina H. Sherrill, Pharm.D., is Postgraduate Year 1 Pharmacy Resident, Charles George Veterans Affairs Medical Center, Asheville, NC; when the project described was undertaken, she was doctor of pharmacy candidate, UNC Eshelman School of Pharmacy, UNC at Chapel Hill. Jamie Cavanaugh, Pharm.D., BCPS, CPP, is Clinical Assistant Professor, UNC School of Medicine, and Assistant Professor of Clinical Education, UNC Eshelman School of Pharmacy; Timothy J. Ives, Pharm.D., M.P.H., BCPS, FCCP, CPP, is Professor, UNC Eshelman School of Pharmacy, and Adjunct Professor, UNC School of Medicine; and Betsy Bryant Shilliday, Pharm.D., CDE, CPP, BCACP, is Associate Professor of Clinical Education, UNC Eshelman School of Pharmacy, and Clinical Associate Professor, UNC School of Medicine, UNC at Chapel Hill.
authors.forename: Keith
authors.initials: K
authors.lastname: Warshany
authors.forename: Christina H
authors.initials: CH
authors.lastname: Sherrill
authors.forename: Jamie
authors.initials: J
authors.lastname: Cavanaugh
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Ives
authors.forename: Betsy Bryant
authors.initials: BB
authors.lastname: Shilliday
mesh_terms: D000368:Aged; D003365:Costs and Cost Analysis; D019317:Evidence-Based Medicine; D005260:Female; D006293:Health Promotion / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D007388:Internal Medicine; D008297:Male; D006278:Medicare / Q000191:economics / Q000458:organization & administration*; D009657:North Carolina; D010044:Outpatient Clinics, Hospital / Q000458:organization & administration*; D010353:Patient Education as Topic; D058991:Patient Protection and Affordable Care Act; D010595:Pharmacists; D012959:Socioeconomic Factors; D014481:United States; D014611:Vaccination