Hello everyone and welcome to the Healthcare Beans podcast, I’m your host James Haven, and today I want to talk about annual wellness visits, and in particular, should we (and by “we” I mean patients) care about these types of medical appointments.

At the outset, talking about annual wellness visits may seem a bit unimportant or even a little boring, but it’s actually kind of surprising what’s goes on behind the scenes with annual wellness visits and by the end of this episode I hope I can convince you to take them seriously.

And for additional context, the annual wellness visit is a pretty important element for implementing value-based healthcare, which I talk about in episode #1 of this podcast. And I will circle back to this topic later in the episode…

As always, the best way to think and talk about healthcare is through the patient experience. So I’m going to share a patient story that I came across a few years back.

Several years ago, while interviewing for an analytics job in healthcare, someone showed me a graph of a single patient’s movement across 10 different hospitals and rehab sites, across a span of 8 months. Now, there’s a particular name for this type of patient, sometimes referred to as a ‘super-utilizer’, but some folks find this term a bit offensive, not really sure why though it might remind people of the term ‘super-predator’ from the 90s which coincided with tough crime laws and really high incarceration rates among black men.

Anyway, the new term is “high-cost, high-need” patients, and this term describes people who end up costing health insurance companies a small fortune in a short time span (3 to 6 months, or 1 year). So going back to that interview, a health system VP shared some graphs with me and asked me what I thought of the data? So as I studied the patterns of movement between facilities, the key thing that jumped out at me was that this patient (we’ll just call him Harry) never went home!

He bounced around the healthcare system for 8 months, wound up costing Medicare half a million dollars, and then he died. Harry’s entire problem began with a poorly managed chronic disease. He went to the emergency department one day, and that was it, he never escaped the health system.

And this is where good preventative care comes in, this where annual wellness visits become important – we want our doctors to spot our health problems long before we spot them ourselves, and certainly before we require emergency care.

To be clear, the wellness visit is an annual touch base with your doctor, that includes a routine check-up, blood test, a vitals check, and a LOT of information gathering. A key thing about annual wellness visits are that these visits are often initiated by your doctor. Someone from your doctor’s office calls you, and wants to set up an appointment. So this is not the usual type of dr visit, where I feel like something is wrong in my body, and I reach out to my doctor to schedule an appointment (this is the other way around).

Now I was talking to a health policy colleague a while back and he did not really understand the significance of wellness visits (or much of primary care in general) and whether these visits were actually effective at keeping people healthy. He didn’t have much faith in a doctors’ ability to spot problems early on, but I would argue otherwise. It’s not just the doctor’s training, or skill or intuition, that’s involved in “problem-spotting”; it’s the data that’s gradually collected on patients over time. And the annual wellness visit is a great data col...

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