MIPS/MACRA has made it more difficult for providers to avoid performing the Medicare Preventive Services such as the Introduction to Medicare Visit (IPPE) or the Annual Wellness Visits. Despite that, many practices are concerned that the Annual Wellness Visit will take too much time and effort from their daily workflow.
There are many reasons for providers to be concerned and one of the top concerns is that they aren’t meeting all of the required elements of the AWV. In this article we will explore some of the ways you can reduce the burden and increase your efficiency.
Prepare your staff:
- Designate specific staff that perform the AWVs. In most cases, there is no need for the practitioner to see the patient during an Annual Wellness Visit. By having licensed staff that specialize in doing the AWV, you maximize your efficiency and know that your patients are being cared for. If you use unlicensed staff to perform the AWV, the practitioner must review and complete the AWV with the patient. Many practices find that hiring a retired RN or LPN provides the best blend of medical knowledge, affordability, and patient satisfaction. (FQHC/RHCs have additional requirements on who can and can’t perform the AWV.)
- Train your staff on the elements of the AWV/IPPE and Medicare’s requirements for these visits. This may be the most important preparation you can make to ensure you are meeting Medicare’s regulations!
Have a consistent Template of Structure in place:
- Have a template or structure to follow during the AWV. By organizing your visit, you can decrease the amount of time needed for the visit.
- The e-AWV® Software creates this structure. If using a professional other than the physician, this can help ensure all the requirements specified by Medicare are being met consistently.
Prepare the patient:
- Prescreen your Medicare patients to ensure they are eligible for the visit. We recommend C-Snap or other Medicare eligibility websites.
- Mail letters to introduce your preventive services to your patients. You will need to educate them on why the AWV/IPPE is important for their continued health.
- When your patients come into the clinic for regular E&M visits have someone designated to ask them to sign up for their IPPE or AWV. This can be the receptionist, Medical Assistants or your LPNs.
- Have receptionists call the patients you haven’t seen in the clinic for awhile and schedule them for their visits.
- Mail the AWV Introduction letter and Health Risk Assessment/Questionnaire to your qualifying patient about 2 weeks prior to their visit. Have extra copies available at receptionist desk in case they forget to bring it with them. This form should correlate directly with the Health Risk Assessment performed by during the AWV/IPPE making it quick and easy to complete during the visit.
- Get most of the paperwork done before meeting the patient. First, have your office staff quickly review the medical records and fill out the healthy histories, medications and immunization from your patient records. Then, review the medical record and Medicare records to determine when the patient is next eligible for preventive screenings, and complete the Wellness Schedule.
- Please note: You must still review the health histories, medications, immunizations and other components of the AWV during the visit with your patient. Not reviewing these elements is directly in violation of the law and Medicare regulations for the AWV/IPPE!
Perform the Annual Wellness Visit:
- When the patient arrives, use the questionnaire they filled out to complete the Health Risk Assessment. Then, review each of their medications and complete the medication schedule; do the same for their list of healthcare providers. Finally, educate the patient on their current health, risk factors and concerns then review the Wellness Schedule.
- Provide recommendations for additional services and make referrals for services needed and indicated by the Annual Wellness Visit.
- Provide the patient with a written schedule of screenings they are eligible for over the next 5-10 years.
- Provide the patient with a comprehensive Health Record. If you have followed the requirements laid out by by Medicare, it is easy to create a health record to give to the patient. This will increase patient satisfaction, decrease time that might be needed to communicate with doctors or hospitals in the future and ensure information from other healthcare providers your patient sees makes it back to you.
By making sure you follow through on the preventive screenings triggered by the AWV, your quality measures will quickly increase and your fear of MIPS should decrease.
Simple steps make the Annual Wellness Visit a viable and beneficial program for your practice. By maximizing efficiency, your patients will enjoy the benefits of the AWV while your practice enjoys the profitability.