The Annual Wellness Visit

Chronic Care Management

The Annual Wellness Visit

The Annual Wellness Visit was introduced in January 2011 and is slowly being adapted by physicians as part of their standard of care for Medicare patients. The benefits of conducting the AWV are many both for patient and physician. With the increase in our aging population and the prevalence of chronic conditions, the Medicare programs aim to delay or modify the onset and progress of these disease states.

The AWV is a critically important initiative designed to improve the health of seniors and reduce long term health care spending by billions of dollars each year. Healthcare has typically been focussed on treatment of acute and chronic disease. The AWV and Chronic Care Management programs are designed to curb health care spending by encouraging patients to have their preventive screening performed.

The AWV will help your practice earn significant credits toward HEDIS and PQRS which safeguards practice reimbursements and provides additional revenue to fight current declines.
Currently, estimates indicate that only 30 to 40% of seniors proactively have their preventive screening performed. AMS is pleased to offer you a choice of 2 different AWV programs to help you find a solution that suits your practice needs and efficiencies

Prevention Plus

allergy banner

This comprehensive AWV solution provides more than just the AWV assessment. We have brought together efficiencies for implementing the AWV to increase physician participation in delivering the AWV as well as enhance practice revenues. A neuro cognitive assessment is offered as part of the program to help detect the 70 to 75% of undiagnosed dementia and predementia currently present in our aging population.

The keys for delivery of the Medicare programs such as the AWV are compliance, efficiency and maximizing the health care providers time. At Ancillary Medical Solutions, we take the pain out of providing the AWV by training your MA to conduct the AWV in as little as 20 minutes and identify patients who qualify for neuro cognitive assessments and Chronic Care Management . The addition of these programs further enhances practice revenue in addition to the pull through services that are typically identified with the AWV.

Many physicians are beginning to use their EMR systems for the AWV however many are not providing the patient with a written report outlining their preventive care plan. Failure to provide this report is not compliant with the Medicare requirements for provision of the G0438 and G0439 codes and can risk claw back in the event of an audit.

Why choose Prevention Plus?

  • The Prevention Plus program and AMS will help you maximize the revenue from the AWV alone as well as provide support and enhancements in patient care. This will reduce your offices time requirement, minimize stress through systems and compliance and generate significant additional profits.

How Does It Work?

allergy banner

Patients can be approached on the day of their office visit to have an AWV or be scheduled to come in. The AWV is performed and those patients identified as having a neuro cognitive risk will be scheduled to return for further assessment. Those with two or more chronic conditions will also be identified and invited to enrol in the Chronic Care Management program.

Those patients that are identified with a neuro cognitive risk will return typically a week later to be further assessed with the assistance of your MA who will be trained for you. This second test takes approximately 40 minutes to complete and enables the physician to bill a further 2 codes as well as a third for the follow up. This follow up has a separate code or can be billed as an additional office visit. These codes typically bill out a further $245 in revenue.

When the Chronic Care Management program is added to this then the visit can create a annual revenue of $900 to $1,000 per Medicare patient per year plus any additional pull through from further suggested care and testing.

Other ancillary programs that can dovetail into this solution include Falls Testing which generates a further $250 and more per patient and ANS testing. These solutions can require a capital purchase which have a high ROI when testing 2 or more patients per day. Alternates to purchasing may be available dependent on your state. Implementing one or both of these devices can return an additional $500 to $1,000 or more per day, even for a small office.

The AWV can become a hub of care for your Medicare patient by producing medical necessity for further testing and care. The AWV has been shown to help improve patient outcomes through the increased awareness of needs of preventive testing and patient engagement.

Electronic Health Assessment

At AMS, we offer an alternate efficient AWV opportunity for your practice to enable you to reduce time and workload on current office staff, help increase the uptake of AWVs performed and quickly provide a compliant solution.

With our Electronic Health Assessment for the AWV, the patient is offered an iPad whilst they are in the waiting room to complete the AWV risk assessment independently. This reduces the time component for office staff to assist the patient and produces a compliant report at the completion of the assessment.

allergy banner

The report can be printed off for the patient and a record maintained in the EMR. The average time for the AWV to be performed in this manner is 20 minutes.

This solution enables any office to provide the AWV to their patients quickly and efficiently. The office can be up and running in a matter of 5 days and the iPad can double as a tool for further Electronic Health Assessments supported by the same vendor. These assessments are available to those 18 and over as well as Medicare patients and produces an additional revenue stream.

Whilst this does not maximize all the revenues of the Prevention Plus solution it does enable efficient and compliant delivery of the AWV to a physicians Medicare patient base.

How Do I Get Started?

These turnkey options, enable the physician to focus on patient care while we provide the support required to maximize the uptake of the AWV and additional revenue options.

For Prevention Plus, the solution is billed per patient use and there are no hidden or ongoing charges. The solution is low cost to get started and simply requires the office to have the space and a computer to commence assessments.

Easy to use reimbursement codes

With our Electronic solution the cost of entry is minimal. This solution combine with the EHA has proven very successful for a range of practice types.

1) Your consultant will work with you to ensure the AWV solution is right for your practice.

2) Sign the start-up agreement and determine if you have sufficient staffing

3) Recruitment assistance is offered with Prevention Plus

4) Let patients know that you are offering the AWV to enhance their care

5) Once training is complete direct Medicare patients to have their AWV performed and watch the revenues increase

6) Average start time is 5 to 10 days to be up and running.

If you are not performing the AWV, you may be losing significant revenue with every 100 Medicare patients capable of producing form $16,000 to $100,000 in revenue. Use the AWV to leverage further services by providing an evidence based approach to patient care and provide the quality credits you seek for PQRS.

Talk to your consultant or contact us to find out the best solution for your practice.