Download Benefits of increasing number of completed preventive care visits

Executive Summary &
Background
Ideal Workflow to Complete Preventive Visits
Patient
agrees
More than 10,000 Medicare patients are provided primary
care services at MU via the Departments of Internal Medicine
and Family & Community Medicine.
Patient receives a
reminder to come
prepared and bring
all medications
Nurse completes the
required assessments
All documentation is
completed efficiently
and in a timely manner
Primary care services include primary, secondary and
tertiary preventive services to patients.
As the result of an
efficient and
effective process
more patients
receive Medicare
preventive care visits
and MU is
reimbursed for the
services
Since 2011, the Affordable Care Act has expanded coverage
for preventive care visits in Medicare patients. Such preventive
care visits under Medicare are of three types, namely
• Welcome to Medicare
• Initial Annual Wellness Exam
• Subsequent Annual Wellness Exam
These preventive visits are reimbursed at an attractive rate.
Each department has invested in measures to complete these
preventive visits although ~500 such preventative care visits
have been completed in the more than 10,000 Medicare
patients over the last 2 years.
Major barriers to the completion of these preventive visits
include:
1) a strict requirement to fulfill a multitude of clinical
assessments with corresponding documentation within a
single visit,
2) a high degree of care coordination, practice workflow,
organization, and EMR support.
Despite improvement measures thus far, the required practice
organization has not yet been achieved.
LIGHT 2 (Leveraging Information Technology to Guide High Tech
and High Touch Care) is a CMS grant funded project focused on
improving primary care practice for Medicare patients. LIGHT2
presents a unique opportunity to both departments who can
utilize both the Hi-Tech and Hi-Touch features to find the creative
solutions necessary to complete preventive care visits in
Medicare patients.
An interdisciplinary team with members from both
Departments and the LIGHT2 team has formed with the purpose
of collaboratively identifying barriers and developing solutions
to increase the number of Medicare preventive visits completed.
Physician discusses and
offers a preventive visit
as a future visit to
patient
Offers explanation and
details
(Hi-Tech) EMR solutions can help
identify patients who are due for a
preventive visit and alert the
physician; alternatively Nurse Care
Managers (Hi-Touch) can educate
and discuss with patients
PSR
schedules
appropriate
next visit
Patient
presents for
preventative
care visit
Physician
reviews and
completes all
needed
assessments
Patients may be reminded by
either Hi-Tech or Hi-Touch
modalities
Hi-Tech
Billing and
reimbursement
occurs
successfully
Hi-Tech/Hi-Touch enhancements
can be used to make
documentation less tedious and
more efficient
Possible
Hi-Tech and
Hi-Touch
solutions via
2
LIGHT
Hi-Touch
Benefits of increasing number of completed preventive care visits
• Development of practice and system level improvements that facilitate completion of Medicare preventive care visits will improve the quality of patient
care as well as increase clinical revenue both of which serve MU School of Medicine strategic goals.