5 steps to get started with annual wellness visits
What’s your practice’s capacity to deliver annual wellness visits (AWVs) and Initial Preventive Physical Examinations (IPPEs)? The answer may mean a major difference in patient outcomes, as well as practice revenue.
Healthcare spending reached $3.5 trillion in the United States in 2017, and that number is expected to climb to nearly $6 trillion by 2027, according to the Centers for Medicare & Medicaid Services (CMS). A wellness and prevention approach is one way to counter the unsustainable level of spending.
“This isn’t about chasing the revenue, it’s really about managing the patient risk and improving healthcare outcomes that has a financing methodology allowed under Medicare to provide this good care,” said Jason Wilson, Value Based Care Adviser with Greenway Health.
Six in 10 U.S. adults have a chronic disease. For more than 58 million Medicare beneficiaries, AWVs can help improve health outcomes. The health risk assessment allows patients to develop a plan with their provider to manage their care.
How to get started with AWVs?
A medical doctor (MD), doctor of osteopathic medicine (DO), nurse practitioner, physician’s assistant, or clinical nurse can perform an AWV. A team of healthcare workers may also support those providers under their direct supervision.
Here’s a step-by-step guide to get started.
Train staff on AWV and IPPE exams. Teach them how to help patients to use data collection tools such as a health risk assessment or a patient health questionnaire (PHQ-9).
Research if any patients will have to wait for such an exam, as some Medicare Advantage Plans reset each calendar year.
Ensure coding staff are knowledgeable about visit types and modifiers.
Train staff on copayment, deductibles, and responsibilities.
Apply a four-pillar strategy. Identify Medicare patients. Assign the team, build patient lists, and develop a communication plan. Engage patients and schedule visits, looking for opportunities to close care gaps and demonstrate shared-decision making. Measure progress, and if something’s not working, adapt and make changes.
Practices should consider their past performance on AWVs, goals for the current year, and their strategy to close quality care gaps, encourage patient engagement, and generate revenue through preventive care. The AWV gives providers a chance to address quality and screening measures that will be required.
“This is your perfect opportunity to have a focused visit to get a lot of that work done,” Jason said, “so that when you do your standard evaluation and management (E/M) visits for other illnesses, conditions, and symptom management, you won’t have as many quality issues to deal with.”
AWV v. IPPE
Medicare designed the AWV to allow providers to develop or update a personalized prevention plan by performing a health risk assessment on patients. Medicare covers such a visit once every 12 months. The patient pays no co-pay or deductible because it’s a preventive service.
Medicare covers an IPPE, meanwhile, for patients within the first 12 months of their enrollment. An IPPE involves a brief physical exam, and allows providers to establish baseline documentation, problem lists, and problem histories, and to get a head start on quality initiatives.
To learn more, click here to listen to Jason’s webinar.
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