We Need to Improve Medicare's Annual Wellness Visit to Better Detect Early Dementia
STAT, July 20, 2018
Cognitive impairment can be an important early sign of Alzheimer's disease, diagnoses of which continue to rise in the US. One goal of the Medicare Annual Wellness Visit (AWV), instituted by the Centers for Medicare & Medicaid Services in 2011, is to assess cognitive function and improve early identification of individuals with cognitive impairment. Timely discovery of cognitive impairment can improve patient-centered care and the management of other medical conditions. Yet a new study suggests that the AWV has fallen short of achieving its goals.
The study, which was reported in the Journal of the American Geriatrics Society, was conducted by a team that included Analysis Group Managing Principal Noam Kirson and Vice President Urvi Desai, as well as researchers from the Indiana University School of Medicine and Eli Lilly and Co. In an op-ed for the health and medicine publication STAT, Dr. Kirson, Dr. Desai, and Nicole Fowler of the Indiana University School of Medicine lay out their finding that the AWV “has not substantially moved the needle for detecting and managing cognitive impairment.” One reason it hasn't done so, they believe, is the lack of specific guidelines and resources to both evaluate patients and properly manage their follow-up if cognitive impairment is suspected. They conclude that “we need more research into how the visit is conducted and what type of additional steps physicians should take afterward to determine how it can deliver on its promise of earlier detection of cognitive impairment and improved management of older adults in the United States.”