Medicare Wellness Visits Made Easier: New Guides and EMR Refinements

November 19, 2017


Since Medicare introduced wellness visits in 2011, many practices, systems and ACOs have come to accept them as useful for improving patient care. The visits are uniquely focused on prevention and offer patients and providers the time to collaboratively review health status, medications and factors effecting wellness. Patients leave the visit with a personalized preventative health plan and providers with a deeper understanding and updated documentation of their patients’ conditions.    

The MaineHealth ACO’s Value Oversight Committee has made these visits a priority, setting a 2018 goal of increasing the number of Medicare and Medicare Advantage wellness visits conducted by ACO participants. To support this goal, the Committee created a work group to develop tools and resources that make scheduling and conducting wellness visits easier for practices and providers.


Guides and Tools Available Online

Many of these new tools, along with legacy materials that remain useful, can be found at MaineHealth’s Medicare wellness visit resource web page, including:

  • Office resources: (Staff Scripts to answer patient questions,  Team-Based Care Workflow and Clinical Workflows)
  • The Patient Visit: (Welcome to Medicare Packet that includes the Welcome to Medicare Letter, What to Bring to the Visit and Health Risk Assessment form)
  • References and Resources:  (CMS and U.S. Preventative Task Force Tools)


Refinements to Epic

Realizing that the success of any patient visit is closely linked to EHR operability, the Value Oversight Committee’s work group worked closely with the SeHR Team to ensure Epic supports wellness visits. Refinements to Epic include:

  • Annual Wellness Sidebar Report (shows all information entered by the clinical support staff)
  • Updated Health Risk Assessment (HRA) questions
  • A Medicare Annual Wellness Visit SmartSet that:
  • Creates the AWV note
  • Makes relevant sections available to place orders, based on the responses to the HRA questionnaire
  • Includes options for interventions based on positive screening results
  • Embeds appropriate diagnosis code and MWV CPT code
  • Embeds follow-up appointment instructions to schedule MWV in one year 
  • Automatically adds information to the patient instructions which prints on the After Visit Summary, includes their Health Maintenance plan

Detailed information about these Epic refinements and how to use them are included in two informational videos that the work group has uploaded to YouTube:

Wellness Visit Provider Workflow in Epic

Wellness Visit Clinical Support Workflow in Epic

Additional Information

For more information or questions related to Medicare Wellness Visits, please contact Martha Ridge, senior director, MaineHealth ACO Network Development or Karen Waycott, manager, MaineHealth Advanced Primary Care Strategy.