Personalized Prevention Plans
Medicare requires 3 sections of information in the report given to the patient at the end of the AWV. Those are: 5-10 preventive services plan, health risk reduction plan, and untreated conditions treatment plan.
Part 1 – 5-10 Year Personalized Preventive Services Plan
Medicare offers 26 preventive services. Our state-of-the-art software automatically reviews the data from a patient’s HRA (health risk assessment) and determines which services the patient qualifies for medically and reviews last date of service to determine eligibility. Preventive services are listed in one of 3 sections – Schedule Now, Due in Future, or Does Not Qualify. This makes it very easy for the patient to know which tests, screenings or counseling to complete now and which ones are due at a later date.
Medicare’s 5-10 year plan requirement can seem confusing. It is not necessary to inform a patient they need a flu shot every year for the next 10 years. The 5-10 year time frame was included because one preventive service, a colonoscopy, can be as far as 10 years in the future.
Part 2 – Health Risk Reduction Plan
This section of the report outlines which health risks the patient has and what to do about them. What makes our system unique is the customized referral database which you build in order to direct and advise patients about risk reduction. For patients who smoke, do you want them to come back for in-office tobacco cessation counseling? Or would you prefer to refer them to online or phone resources such as Quit Now websites or 800 numbers? If a patient has a family history of diabetes, for example, but has not been diagnosed, their Personalized Prevention Plan automatically includes a handout based on information from the CDC and NIH. If a patient is having issues with activities or independent activities of daily living, would you like to have them return to the office or is there a referral you normally provide.
Part 3 – Untreated Conditions Treatment Plan
The Annual Wellness Visit is a great discovery tool. A long list of possible conditions or symptoms is reviewed by the patient, allowing them to indicate any that they feel are not being addressed or treated. In addition, patients are asked if they have any other concerns. General health and pain levels are collected and reviewed. Most treatment plans direct the patient to return to your office for follow up.
The current group of Medicare patients are not used to the idea of an annual wellness visit. Their first thought is, “I just had my physical” or “I just saw the doctor”. With our AWV Tele-Service and AWV+4 services, we take the time to explain the benefits of an AWV to them, why Medicare believes it is so important, and how it is different from a physical or office visit. In addition, we describe why Medicare waves the co-pay for the AWV.
The required report (PPPS) which we create and provide to each patient is very specific about what the patient needs to do next. However we all know some patients are better than others with follow through. That is why we also provide a Summary Report for your practice which outlines which preventive services the patient needs orders for and which issues or preventive services the patient needs to return to the office for. The pull through visits not only help the patient keep on track, they also provided additional revenue for your practice.
Patients might not follow up with every referral or recommendation the first year. However we have seen, as each patient becomes accustomed to the AWV and experiences the benefits, many patients become more responsible for their follow through and lifestyle choices.
Growing Your Business
Our system connects directly with Medicare’s HETS (HIPAA Eligibility Transaction System). That allows you or us to check patient eligibility for the AWV for all of your traditional Medicare patients and contact those that don’t regularly come to the office. If a patient won’t be eligible for a few months, our software keeps track of the next eligible date of service and reappear 60 days before.
Depending on which AWV service you select, we can do all or some of the work on your behalf. Print and mail a letter from you explaining AWVs and their importance. If this is not the patient’s first AWV, then we send a letter informing them to it is time for their next AWV. We follow up by calling patients and completing their health risk assessment over the phone. This cuts down the time the patient will spend at the office. We collect about 277 data points (male/female questions differ). Our caller then sets an appointment for the patient to come to the office.
If you need decide you don’t have the in-office resources, when the patient arrives, our AWV Nurse Specialist takes over. He or she will collect some additional in-person data. Our unique, state-of-the-art software program takes the patient’s data, runs it through over 100 complex preventive and risk algorithms, and products a very unique report for the patient complete with referrals, which you have defined and customized.
Totally hands off. If you are already doing the AWV, think of the time that will be freed up for your staff. If you don’t currently provide the AWV, we make it possible without added risk, staff, or time. Most practices realize on average $100 per patient without any work other than checking the patient in and out.