Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.


Date of Graduation


Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing


Jeannie Scruggs Corey

Jeffrey Feit


The passage of the Patient Portability and Affordable Care Act had a goal of increasing access for preventive care. The Medicare Annual Wellness Visit (AWV) has been a free yearly, comprehensive preventive care opportunity for most Medicare beneficiaries since 2011. Because of the time intensive nature of these visits, the overall national completion rate for them has been low as providers often perceive time and resource constraints. Registered Nurses (RNs) have the skill set to complete these visits with minimal provider involvement. Rural residents often face health care access barriers and outcome disparities, and Rural Health Clinics (RHCs) are a resource intended to increase access to health care in these disparate areas, but Registered Nurses are an underused resource in this setting. This program evaluation examined the impact of RN-led AWVs on preventive care completion in 5 RHCs in northwestern Virginia. These visits increased access to primary care while closing gaps in screening and preventive care including breast and colon cancer screenings with 66.7% and 45.8% completion rates after the visit. The visits also demonstrated emergency department encounters and hospital admission rates (19.9% and 8.8%) that were lower than the 2018 Medicare national average (27% and 15%). Potential role sustainability was demonstrated with the new generated income (approximately $45,000 in 6 months) and productivity for the clinic.



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.