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Medicare Sees Strong Interest in Annual Visits Covered Under Health Care Law

By Jane Norman, CQ HealthBeat Associate Editor

March 16, 2011 -- Annual wellness visits now fully covered under Medicare have proven popular, with more than 150,000 Americans taking advantage of the new benefit as of late February, according to statistics provided to CQ HealthBeat by the Department of Health and Human Services.

HHS Secretary Kathleen Sebelius will tell members of the Senate Finance Committee that prevention is one of the key elements of the health care law, which will be one-year-old next week. And she will say the annual wellness visits are an example of early success. Until enactment of the law (PL 111-148, PL 111-152), seniors and people with disabilities received a one-time free visit with a physician when they joined the Medicare Part B program but had to pay for annual visits after that.

The uptick in the number of people accessing that wellness benefit also means cost savings, stressed administration officials, speaking on background. Peer-reviewed studies have shown that there are significant cost savings in the long run if chronic diseases like hypertension are detected early, or if diabetes is found and treated before it becomes debilitating, they said. In addition, immunizations for pneumococcal disease are under used by the Medicare population even though seniors die at the highest rate from such infections, they added.

Between Jan. 1 and Feb. 23 there were 151,764 beneficiaries who participated in annual wellness visits with physicians, HHS officials say. That adds up to nearly 2,800 seniors and people with disabilities per day seeing a doctor, administration officials said.

Costs for such wellness assessments normally would be $160 for a first visit and $105 for subsequent visits, officials said. Now the visit is free of charge. During the appointment, the physician and patient are supposed to develop or update personal prevention plans taking into account medical and family history, detection of any impairments, potential risk factors from depression and review of the patient's functioning ability and level of safety. Doctors can also give their patients advice on daily health habits and refer patients to other agencies or services for counseling or programs.

Officials said that Medicare coverage of the annual visit also means that employer-sponsored retiree programs will save money because they don't have to pay for the visits. States will also save money if they have covered the visits for beneficiaries in the past to fill in gaps, and seniors will save money if they've been buying Medigap coverage that pays for such visits.

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