Tips for tackling Medicare wellness visits

Author(s):

With the Medicare population primed to double in size soon, you may be wondering how you'll take on all those annual wellness visits. A recent study offers some insight.

Medicare costs are expected to increase 80% over the next decade as the number of people covered by the program swells to 80 million by 2030, compared with 47 million today.

A new study from TeleVox Healthy World Report, titled “Healthcare Change: The Time is Now,” aims to help you and your primary care physician (PCP) peers identify the biggest needs of that population and develop ways to offer them better wellness care.

Focusing on preventive care rather than treating illness will reduce hospital stays and spending on chronic conditions, according to the study. Currently, more than half of the baby boomers surveyed say they do not believe they are in overall “good shape,” and nearly 30% say becoming healthy is a struggle. That’s in addition to the already large portion (70%) of Medicare beneficiaries who reported at least once chronic condition in 2008. Nearly 40% reported two to four chronic conditions, and 7% reported five or more.

New Medicare wellness efforts have been put in place, but the study notes that few beneficiaries have taken advantage of the programs, either because they didn’t know about them or their PCPs did not offer them.

According to the study, only 3.8%-1.2 million out of 31.5 million-of senior citizens took advantage of a new program started last year as a part of federal health reform efforts to offer annual wellness visits. TeleVox says some patients don’t know they are entitled to the benefit and that physicians are hesitant to tell patients about it because of the financial effect on their practices.

The program creates billing challenges and time problems for PCPs, according to the research, and 66% of the providers surveyed by TeleVox say the are poorly prepared to create wellness plans tailored to the needs of these patients. Another 71% say they are not prepared to engage patients throughout the year with communications to help them adhere to such plans.

But PCPs can be reimbursed by Medicare for regularly providing patients health information and education, and TeleVox says doctors must begin to leverage the skills of other staff members and take advantage of new electronic assessments to help conduct these visits.

Ideally, a PCP could have patients participating in Medicare annual wellness visits complete and submit forms electronically before the visit, detailing past medical history, family history, and a list of current medical providers and medications, and they also could complete a questionnaire on health habits.

If it’s not possible for patients to submit the forms electronically before visiting the office, they could mail the forms before the visit, or a staff member could input the data electronically when the patient arrives. Personal prevention plans then could be created through automated programs based on the patient’s own conditions and risk factors, and PCPs could select a pre-packaged series of automated reminders that match a patient’s treatment plan.

TeleVox, a provider of appointment reminder systems and physician Web site services, conducted the survey by email and online, polling more than 2,200 healthcare providers and more than 1,000 American adults.

Go back to current issue of eConsult