• Derjung M Tarn, Wilson D Pace, Chi-Hong Tseng, Elisabeth Callen, Natalia Y Loskutova, Kurt C Stange, and Neil S Wenger.
• From the Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (DMT); DARTNet Institute, Aurora, CO (WDP); Division of General Internal Medicine/Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (C-HT, NSW); American Academy of Family Physicians, Leawood, KS (EC, NYL); and Center for Community Health Integration and Department of Family Medicine & Community Health, Population & Quantitative Health Sciences, and Sociology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH dtarn@mednet.ucla.edu.
• J Am Board Fam Med. 2023 May 8; 36 (3): 501509501-509.

IntroductionInterventions are needed to promote utilization of the Medicare Annual Wellness Visit (AWV), an underused opportunity to perform screenings and plan individualized preventive health services.MethodUsing remote practice redesign and electronic health record (EHR) support, we implemented the Practice-Tailored AWV intervention in 2021 (during the COVID-19 pandemic) in 3 small community-based practices. The intervention combines EHR-based tools with practice redesign approaches and resources. Outcomes included completion of AWV and fulfillment of recommended preventive services.ResultsAt baseline the 3 practices had 1,513 Medicare patients with at least 1 visit in the past 12 months. AWV utilization went from 7% at baseline to 54% 8 months postintervention implementation; advance care planning increased 10.7% (from 7.9% to 18.6%); depression screening increased 16.3% (from 51.7% to 68.0%); and alcohol misuse screening increased 17.3% (from 42.6% to 59.9%). Every individual preventive health service was received more often by patients with an AWV than those without. At the patient level, fulfillment of all eligible preventive services (of a maximum of 12 evaluated) went from 47.5% to 53.8% (P < .001). Subgroup analyses showed that patients with AWVs completed a greater percentage of their total recommended preventive health services than those without an AWV.ConclusionVirtual implementation of an intervention that combined EHR-based tools with practice redesign approaches increased AWV and preventive services utilization in Medicare patients. Given the success of this intervention during the COVID-19 pandemic (when practices had many competing demands), greater consideration should be given to delivering future interventions virtually.© Copyright by the American Board of Family Medicine.

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