Annual Wellness Visits And Hearing Health

The Medicare Annual Wellness Visit (AWV) is a benefit aimed at promoting health through risk-modifying screenings and assessments. The eventual goal of the program is to shift healthcare focus away from acute care while promoting early identification and shared management of health problems. The AWV is an individualized health prevention plan for older adults with the central part being a health risk assessment questionnaire.

Screening Questionnaires

The primary care physician can use screening questionnaires to assess mood, falls risk, cognitive status, and hearing status. However, an analysis of studies determined that two-thirds of primary care physicians do not include a hearing screening in the AWV. The reasons may be the view that hearing loss is part of the aging process or the cost of interventions. The reasons for hearing health screenings are documented and include:

• Untreated hearing loss leads to brain atrophy
• Dementia and Alzheimer’s disease
• Danger from the risk of falls
• Emotional health
• Listener fatigue
• Relationship challenges

Even though the amount of attention given to untreated hearing loss and the problems it can cause is on the rise, no significant progress in early recognition of hearing loss exists. Hearing healthcare professionals must take the lead in educating primary care physicians in the importance of hearing screenings.

New Recommendations

In 2011, the U.S. Preventative Services Task Force (USPSTF) concluded that evidence was insufficient to weigh the benefits and harms of hearing loss screenings for asymptomatic adults aged 50 years or older. Recently, the USPSTF revisited the issue and published a research plan with the intent of new recommendations. The plan calls for the measurement of health outcomes, including hearing health. As the primary care physician is intimately involved in this process, hearing healthcare professionals must inform these physicians of the importance of audiological interventions. Hearing healthcare professionals must educate physicians in the consequences of untreated hearing loss, the contribution of communication to overall health, and the importance of communication to patient-centered care.

Four-Step Toolkit

Engagement and collaboration are vital to improving hearing healthcare. A four-step toolkit for primary care physicians may help to encourage hearing care at annual wellness visits. Hearing healthcare professionals can develop these steps for primary care physicians, which include:

• Helpful tips designed to help primary care physicians initiate conversations about hearing health with their patients.
• Tips to help primary care physicians identify any patients who have hearing problems.
• Practical strategies that are designed to help physicians conduct hearing loss screenings.
• Tips that primary care physicians can offer their patients regarding the management of hearing loss.

The AWV is designed to promote health through risk-modifying screenings and assessments. Untreated hearing loss is a significant concern for many older Americans, so, logically, a hearing screening should be included in all wellness visits. To optimize AWV benefits, collaboration with physicians is critical. Increasing engagement improves the chances of identifying hearing loss during annual wellness visits. Hearing healthcare professionals can take a lead role in educating primary care physicians in the four-step toolkit to promote early hearing loss identification.