Medicare Annual Wellness Visits: A Scoping Review of Current Practice Models and Opportunities for Pharmacists.

OBJECTIVE

To explore the existing practice models and practice opportunities surrounding pharmacist-delivered Medicare Annual Wellness Visits (AWVs), with the goal of improving patient access through advanced pharmacy-based health services.

DATA SOURCES

English-language articles published in peer-reviewed journals from January 2011 to March 2018 were reviewed by searching PubMed and Google Scholar databases using permutations of terms such as "pharmacist/pharmacy," "Medicare," "Annual Wellness Visit," "develop/development," and "implement/implementation."

STUDY SELECTION AND DATA EXTRACTION

Original articles reporting resources (inputs), processes, and programmatic outcomes (uptake and delivery, interventions made, financial models, satisfaction) of pharmacist-delivered AWV services were retained.

DATA SYNTHESIS

Eight articles describing 6 unique studies representing current pharmacist-delivered AWV practices were included in the final review. All identified articles used observational study designs and were published in peer-reviewed journals from 2014 to 2017. Five studies utilized staff (in-house) pharmacists working in internal or family medicine clinics via collaborative practice agreements; one study described a model for outsourcing AWV services through a community pharmacy. Pharmacists completed 37 to 300 AWVs and performed both medication- and non-medication-related interventions, with a mean of 3.5 to 5.4 interventions/patient. Quarterly revenue ranged from $3750 to $22 340 (USD), with 40 pharmacist-hours required for initial program development.

IMPLICATIONS FOR PATIENT CARE AND CLINICAL PRACTICE

This scoping review will serve as a guide for pharmacists wishing to implement AWV services in their own practices.

CONCLUSIONS

There is opportunity for ambulatory/community pharmacists to expand their practices to include AWV services in states that allow collaborative practice agreements. Interprofessional collaboration between physicians and pharmacists can optimize and aid adoption of pharmacist-delivered AWV services.