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3 Ways Providers Benefit from Boosting Annual Wellness Visits

Analysis  |  By Debra Shute  
   June 15, 2017

Some providers regard pushing the preventive benefit to Medicare beneficiaries as a "money grab," but executives at Bon Secours Health System, Inc., say the visits are improving patient health.

Since its 2011 inception, uptake for Medicare's Annual Wellness Visit, designed to address health risks in aging adults has remained slight. It is provided at no cost to beneficiaries, and aims to identify risks for falls and dementia.

For various reasons, however, it's not unusual for physicians to question whether the AWV offers any particular value not otherwise delivered during routine primary care.

Thus, when Bon Secours Health System began a system-wide initiative to increase AWVs among its patients on Medicare, the barriers were mostly cultural, according to Dan Hager, MHA, program manager for physician and ambulatory services for the multi-state system.

Hager co-presented about the topic at the American Medical Group Association's 2017 Annual Conference, in Grapevine, Texas, March 22–25, and followed up with HealthLeaders by phone.


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"A lot of providers, if their systems are wanting to push AWV, have a bit of resistance because it may seem like a money grab, or just a way to do an extra visit to get reimbursed for," he says.

"It was incredibly important that it not be about the money so much as it was about the value that we were driving for our patients, for our community, and even for our payer. CMS is asking us to be good stewards by making this available, and we want to make sure we're delivering the aims they intended when they created the opportunity to do an AWV."

What's more, as the system upped its AWV rate from 26% to more than 55% within approximately two years, it recognized three clear benefits:

  1. Improved quality measure performance. While Hager is careful to note that the causal relationship is unclear, Bon Secours' Medicare beneficiaries who had an AWV in 2015 were significantly more likely to receive breast cancer screening, colorectal cancer screening, pneumonia vaccination, and influenza vaccination.
    While just 53.6% of patients older than 66 without an AWV got a pneumonia shot, for example, 84.5% of those who attended an AWV were immunized.

  2. ACO growth. During the system's AWV initiative, Bon Secours also increased the number of unique lives attributed to its Medicare Shared Savings Program ACO from 55,000 to upwards of 70,000.
    "We really see the AWV as being a crucial factor in that because of how it helps establish that relationship with the primary care and those Medicare beneficiaries," Hager says.
     
  3. Culture-building. Despite the ambitious nature of rolling out a strategic initiative to boost AWV rates across the entire system at once, Hager says the effort helped pull the network together.
    "It was actually very well timed because we'd been in the midst of a primary care growth strategy to rapidly increase the amount of PCPs we had in our communities," he says.
    "The AWV came around the mid-point of that growth effort and provided a great opportunity for us to establish an identity across all of those diverse providers in the practices and give us something we could all work on to get there."

As for how Bon Secours managed such dramatic results, Hager credits solid communication and top-level engagement.

"It challenged us to innovate to find new ways of thinking about it and challenged us to stay true to the purpose of the AWV and make sure it didn't turn into a numerator-denominator exercise," Hager says.

Debra Shute is the Senior Physicians Editor for HealthLeaders Media.


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