Medicare Annual Wellness Visits Challenges

Medicare Annual Wellness Visit Challenges with Workflow

The Annual Wellness Visit (AWV), despite its many benefits, is an under-utilized procedure.  To perform within a clinic an Annual Wellness Visit is challenging.  However, when performed correctly AWV’s are a beneficial exam for patients and profitable for the practice.  This article focuses on the AWV challenges of the workflow, the components for a successful Annual Wellness Visit and how ThoughtSwift systematically addresses those issues.

Workflow Challenges of Annual Wellness Visit Overview

To understand the challenges with AWV workflow, it’s important to explain how they are reimbursed.  Unlike a regular Evaluation and Management (E/M) Call, Medicare Annual Wellness Visits are paid per exam not time.  So if you spend thirty minutes with a patient or two hours, the practice is paid with the same G-code. Provider payment, based on the exam, is designed to keep Medicare costs predictable.  However, it also shows the great need for staff and provider efficiency.  

Components of Medicare Annual Wellness Visit

To perform an AWV the provider must collect the information for the Health Risk Assessment or HRA.  This is a list of 50-100 questions depending on patient lifestyle, history and health.  Once the HRA is collected, the provider must review the information, write up a patient care plan which is handed to the patient and placed within the patient chart, perform the exam and notate for the exam in EMR.  Because of the extensive nature the Medicare Annual Wellness Visit all documentation is typically more extensive than an E/M visit and consequently takes more time.  Patient care gaps uncovered such as specialists and  services, are referred by the coordinator and provider scripts sent to the lab.  The activities stated above can take anywhere from an hour for a simple patient, to two hours for patients with complex care.  Because the AWV addresses so many patient topics, the exam often takes longer than a normal E/M call.  If a patient has neglected to see their provider in the past or if their care has changed over the year the staff may have many specialists, services, and labs to authorize and coordinate.  Additionally, the AWV contributes to HEDIS and MIPS. Missing one care point consistently can affect the future revenue, or contract status of a practice.  So, It’s important to carefully look over each report to ensure all activities are performed to receive the highest HEDIS, MIPS and Medicare payment to be successful. 

Implementing Medicare Annual Wellness Within a Practice Environment

Often overlooked, the lengthy nature of the Medicare Annual Wellness Visit can affect the workflow when added to the daily routine of practice.  Patients who are late or forget their appointment can severely affect the practice workflow and consequently profitability.  Even when patients arrive on time the flow of regular AWV within a weekly practice doesn’t fit neatly within the 15-minute provider time slots in a humming daily practice.  AWVs can disrupt the workflow timing making providers late for appointments or staying late in the evening finishing paperwork.  Workflow disruption contributes to provider burn-out.  Not to mention the need for staff to constantly balance the schedule instead of focusing on patient needs.  

ThoughtSwift’s Medicare Annual Wellness Solution

ThoughtSwift’s unique software solves many Annual Wellness Visit issues for staff and providers.   The Annual Wellness Visit HRA can be gathered by staff at the time of the appointment, through telehealth or by the ThoughtSwift team prior to the scheduled appointment.  These options give flexibility to the practice to maximize workflow and revenue.  No matter the method chosen, by the time the patient answers the last question an HRA and Patient Care Report are automatically generated.  The Patient Care Report and the HRA are placed within the patient chart within the EMR.  The ThoughtSwift system ensures no missing components.  When an AWV is placed in the chart, it is complete.

ThoughtSwift’s Health Risk Assessment

ThoughtSwift’s unique, color-coded HRA displays a customized, whole-patient understanding of a patient.  This color-coding is fast to read, comprehend, and leads to better questions for providers and better results for patients.  HRA displays in segments how patients answered the questions giving the option for providers to take a deeper look why a patient is a candidate and address the issue. While we can’t remove the burden of notating the chart, ThoughtSwift’s HRA makes notation faster with relevant information easily listed including CPT Codes and ICD-10 needed.

ThoughtSwift’s Patient Care Report

ThoughtSwift’s Patient Care Report is a synopsis of the HRA.  This report is placed into the EMR along with the HRA but also printed/sent electronically for patients.  The care report for the patient, is generated instantly and waiting in the patient’s chart.  Providers proceed through the checked items of counseling and services in a list format.  This list ensures nothing is missed for HEDIS, MIPS but also billing.

labs, services and vaccinations are all listed so nothing is missed. Listed in sections, it’s easy for the provider to efficiently order referrals and scripts.  For clinics, the AWV can now neatly fit within 30 minutes and fit within the workflow rhythm of a daily practice. 

ThoughtSwift Analytics

ThoughtSwift provides analytics to ensure all care gaps and patient information needed is available on one spreadsheet or integrated into a patient population system.  

ThoughtSwift removes the clinic pressure for efficiency and accuracy in performing Annual Wellness Visits making them a beneficial exam for the clinic and providers.  During the time it takes to perform an AWV ThoughtSwift enables add on services often overlooked.  For more information contact ThoughtSwift.

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