Prevention is rapidly becoming the dominant phase of physician care. Although there are still significant challenges to the “preventative concept”. Wellness is often misinterpreted as only for the Medicare population. Medicare-aged patients are a high-value population for providers, but they are in my estimation, 3 additional categories of Wellness targets in addition to Medicare; Pre-Medicare (50-65), Mid-lifer group (40-50), and the Work Active group (30-40).
Providers are mostly overworked! Ninety percent of the providers we talk to are exhausted but have adapted to the lifestyle they lead as a physician. But it’s important to understand and embrace ways that can even out the workflow for the physician as well as his/her practice. Physicians are aware of the burden they add to their staff each day, and in many cases aren’t comfortable with it, but they see no other option. CMS has created the model through the “Annual Wellness Visit” to increase engagement while at the same time creating compliance that allows less on-hand work from the physician.
CMS Guidelines on who can perform the Annual Wellness Visit:
Who is Eligible to Provide the AWV with PPPS?
* A physician who is a doctor of medicine or osteopathy (as defined in section 1861(r)(1) of the Social Security Act (the Act); or,
* A physician assistant, nurse practitioner, or clinical nurse specialist (as defined in section 1861(aa)(5) of the Act); or,
* A medical professional (including a health educator, registered dietitian, or nutrition professional or other licensed practitioner) or a team of such medical professionals, working under the direct supervision (as defined in CFR 410.32(b)(3)(ii)) of a physician as defined in the first bullet point of this section.
How can you increase the participation?
The most efficient way to increase the AWV volume is simple.
1. Allocate a staff member who is calling those patients who have not completed an AWV.
2. Partner with a company who specializes in AWV and has a staffing component.
3. Establish the metrics you want to reach within your organization by doing it internally, and/or with an external vendor partner.
4. Make sure the partner has a tool that can identify additional patients eligible for Chronic Care Management.
Many times, there are misconceptions that these programs work unilaterally. On the contrary, CMS created these programs to work seamlessly together. They just forgot to fully emphasize that. When you have the patient in the office for a data collection encounter, what better time to “educate” them on the eligibility and importance of Chronic Care Management.
We should not stop at just focusing on Medicare patients because studies show that the under 65 population is more hyperbolic when it comes to rushing to the EHR. They also have a larger fear of seeing their PCP and being presented with the unflattering news. Due to these measures, physicians don’t place a focus on Wellness prevention of these other groups. There should be a larger spotlight placed in the under 65 patients as well. There should be a consistent focus consistent across the country, specifically, targeting education, early prevention (detection), and care management. But it’s not a one-way street where the provider is the only one investing. Educating the patient and then engaging them is a key component.
In summary, the increasing AWV participation through various tools is very attainable. You have access to these tools today. As always, physicians must adjust to the changes but there are ways to have more access to your patient by seeing them less. Sign me up I am interested in that.
Stay tuned for more Blog Posts from Healthy Plus. If you have questions or comments, please feel free to contact him at firstname.lastname@example.org