Developing a pharmacist-led medicaid annual wellness pilot program

PURPOSE: Medicare annual wellness visits (AWVs) focus on overall patient wellness and disease prevention, increasing preventative care utilization. Despite being a counterpart, there are no Medicaid AWVs. The purpose of this study was to evaluate the feasibility of Medicaid AWVs in an independent pharmacy within an academic institution. 

METHODS: This was a prospective exploratory research study. The primary objective of this study was to identify the number of Medicaid patients who participate in a Medicaid AWV. Secondary objectives included quantifying the number of interventions and provider recommendations made by pharmacists, identifying the percentage of visits billable for reimbursement, performing economic analysis, and evaluating patient satisfaction. Between February 1 and April 30, 2025, patients were contacted to schedule an appointment. During Medicaid AWVs, point-of-care testing was performed, health risks and social determinants of health documented, and recommendations provided. Patient satisfaction following visits was evaluated. Pharmacists are becoming more involved in primary care and conducted these novel appointments to further expand the scope of practice. 

RESULTS: Twelve appointments were scheduled, and 6 Medicaid AWVs were completed during the 3-month period. The mean number of risks or conditions identified per patient was 9 (SD, 1.67). The mean number of interventions per patient and mean number of recommendations per patient were 9 (SD, 1.67) and 4 (SD, 1.26), respectively. The number of billable visits was 4 (67% of completed visits). Economic analysis revealed that allocating 1 pharmacist full-time equivalent (FTE) to perform Medicaid AWVs could be feasible, depending on the population. In the satisfaction survey, 5 patients rated the service at the highest level (a mean [SD] score of 79.67 [0.82] points out of a total possible score of 80 points). 

CONCLUSION: Pharmacists are uniquely poised to conduct Medicaid AWVs due to their accessibility and primary care scope. Pharmacists could utilize the forms and workflow developed in this study to impact patient health, decrease long-term healthcare costs for Medicaid patients, and receive reimbursement through billing as Medicaid providers.