Bringing Wellness into the Doctor's Office

Wellness initiatives are generally administered by company physicians, wellness companies or disease management organizations.  However, one offshoot of the Accountable Care Act is the requirement of Medicare providers to devise a Personalized Prevention Plan for Part B Beneficiaries.  This is apparently in line with the law’s intent to foster greater preventative services for the population.  Prevention is a major theme in wellness.

The visit is coined as Annual Wellness Visit (AWV). Among the benefits include the fact that the provider will administer a HRA health risk assessment  which can uncover various risk factors that if addressed early enough can prevent disease.  

Sample HRA (link -www.prochange.com)

A second major benefit is that he or she will devise a 5 year schedule outlining which screenings and immunizations a patient needs. It can replace the Welcome to Medicare Visit as a requirement for Part B patients but you are not eligible for this until after 12 months of becoming a Part B beneficiary or within 12 months of IPPE (Initial Preventative Physical Exam). It appears that CMS has this because they want the first year to be a trial (Dr. Chawla's opinion). The only drawback is that the AWV doesn’t cover any physical exams.

This represents another step in empowering the provider to become the primary furnisher of preventative services and not someone who treats sicknesses.

The physician is in the optimum place to administer powerful tools such as the HRA, which when used with follow-up counseling, has been shown in studies to help providers pinpoint risk factors that are not found during routine visits.  Furthermore, prevention planning has been shown for years to help health departments and agencies such as the CDC improve outcomes for population. Government regulations or the lure of higher reimbursement from payers is often what it takes to start such transformation. In the next several years as health reform completely rolls out we will watching to see how “sick care” changes to “well care”

YouTube videos by Dr. Chawla site links -OpeEMR Scheduling and OpenEMR SOAP Note