Reasons for underutilization are related to personal, organizational, structural, and system barriers and challenges for beneficiaries and providers. Beneficiaries are often unaware of the availability of this visit (or the fact that it is free). They may not understand the value of nor attach strong importance to a visit solely focused upon prevention. Providers report being confused and overwhelmed regarding AWV requirements and guidelines, leading to ambivalence concerning visit implementation (Bluestein, Diduk-Smith, Jordan, Persaud, & Hughes, 2017, Cuenca, Lozoya-Flores, et al., 2012, Simpson, Edwards et al., 2018). Most practices lack an efficient and effective workflow to support implementation of AWVs, thereby consuming limited practice time (Cuenca, Lozoya-Flores, et al., 2012). These issues are compounded by a steady decline in the numbers of medical students and residents entering primary care, particularly family practice or general internal medicine, at a time when there are growing numbers of Medicare beneficiaries requiring primary care services (Naylor & Kurtzman, 2010). Meeting


This is the accepted manuscript of Vicki Simpson, PhD, RN, CHES, Policy and Practice Recommendations for Nurse Practitioner–Led Medicare Annual Wellness Visits, Public Policy & Aging Report, Volume 29, Issue 1, 2019, Pages 13–19, https://doi.org/10.1093/ppar/pry046


Nurse Practitioners, Health Promotion, Annual Wellness Visit, Medicare, Care of Older Adults

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