How Annual Wellness Visits improve patient outcomes and organizational revenue

February 6, 2020 |  Government Regulations, Population Health, Patient Engagement

Close-up of assessment elderly patients blood pressure

Even with recent increases in the percentage of Medicare recipients who have Annual Wellness Visits (AWVs), less than 20 percent of eligible patients availed themselves of this new benefit provided under the Affordable Care Act, according to a JAMA study

At Frisbie Memorial Hospital, we saw this as an opportunity to enhance population health efforts and increase revenue through a relatively easy appointment.

In response, the hospital and its affiliate medical offices created The Phoenix Project, a new initiative to increase the number of AWVs, resulting in higher patient engagement and raising much-needed income in the form of federal reimbursements.

To achieve these results, we realigned some of our administrative operations and clinical workflows to make sure we were catching more of our 6,000 Medicare-eligible patients and providing them with this no-charge evaluation.

Before we review the outcomes of this new initiative, let’s take a look at the AWV and how Frisbie incorporated it into our overall efforts.

A benefit for patient and providers

Established under the ACA in 2010, Annual Wellness Visits are intended as a way for providers to get important health information from patients and determine appropriate health plans.

Not to be confused with annual physicals, AWVs include a review of medical and family histories, a cognitive assessment, and a hearing test designed to look for signs of dementia and Alzheimer’s.

Our new process starts a few days before the appointment, when the front desk staff checks for patients who are scheduled for a routine follow-up and are eligible for an AWV. 

If a patient is eligible, our staff then adds the AWV (typically 10 to 15 minutes) onto the existing appointment, and the portal alerts the patient that they have the AWV survey to complete.

That information then goes into the patient’s chart and is ready for the doctor to review during the appointment.

We’ve found that having patients complete the survey online ahead of the visit reduces the amount of time that patients sit in the waiting room, and saves the provider three to four minutes during the visit — allowing more time to talk with the patient. 

After the appointment, we bill for both the routine visit and the AWV, as well as any other follow-up exams or screenings that can be billed to Medicare.

A key part of our project was the patient portal, and more specifically our providers’ help in encouraging patients to use it.

Our patients responded to that encouragement, and appreciated the portal because they could see their PPPs in their care plan, complete registration questions ahead of time, and communicate with their providers without needing a formal appointment.

That between-visit communication means we can respond to patients' care needs without requiring them to return to the hospital or clinic, and it provides additional revenue because the Centers for Medicare and Medicaid Services recently approved reimbursements for time associated with electronic communication.

Results show benefits for patients and providers 

As we’ve evaluated the new AWV program, the first thing that jumps out was the numbers: Before Project Phoenix began in 2017, Frisbie performed zero AWVs per day, whereas Frisbie and its affiliate sites now conduct between 22 and 120 AWVs per day at each of our six facilities.

In addition, the project paid for itself with the new revenue it generated.

We also found that the portal reduced administrative burdens on the registration staff, since patients can complete registration updates before their appointment.

Our doctors have been overwhelmingly positive on the new project, since they can more effectively treat more people, and can identify population health trends that we can then address.

In Frisbie’s case, we have a significant number of diabetic patients who may be overdue for treatment or need reminders to keep up with their medications — and we are now able to provide that support through the AWV program and the patient portal.

Most importantly, our patients feel more empowered to take an active role in their own care; they appreciate the convenience of the portal; and they value having more informed conversations with their doctors.

As healthcare continues the shift toward value-based care, it’s critical for hospitals to identify new ways to treat patients and boost the bottom line — and an AWV program like Frisbie’s is one example of how to achieve those goals.

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Written by Deborah Harrigan, MD, Medical Director, Physician Services, Frisbie Memorial Hospital

Dr. Deborah Harrigan is the Medical Director for the Physician Services at Frisbie Memorial Hospital in Rochester, NH. She is a family physician who has been practicing in Rochester for 20 years, functioning as medical director for four years. She was the physician champion for Frisbie Memorial Hospital's MEDITECH implementation in February 2017. In 2016 she was inaugurated as the 185th president of the New Hampshire Medical Society. Dr. Harrigan is a member of Frisbie’s Medical Executive Committee, the Medical Staff Bylaw Committee, and the Technology Assessment Steering Committee. Dr. Harrigan graduated from Tufts University School of Medicine in Boston, Massachusetts. She completed her Family Medicine Residency at the Beverly Hospital in Beverly, Massachusetts. She is certified by the American Board of Family Medicine. Her areas of clinical interest include geriatrics and population health.