MaineHealth ACO Providers Achieve Annual Wellness Visit Goal

September 17, 2018

Recent data from the Medicare Shared Savings Program (MSSP) and the Martin’s Point Generations Advantage health plan indicate that MaineHealth ACO providers are successfully increasing the number of annual wellness visits (AWVs) they complete annually. The ACO’s 2018 goal for both programs is to increase annual wellness visits by ten percentage points over the 2016 level. According to the newly available data, the ACO’s individual regions all met the Generations Advantage goal and the ACO as a whole met the MSSP goal well ahead of schedule. This accelerated pace of improvement is the direct result of intensive work by providers, practice managers and practice staff to integrate annual wellness visits into their already busy and complex flow of care.

Looking at the results more closely, MaineHealth ACO providers increased the portion of Generations Advantage beneficiaries receiving wellness visits from a baseline of 50.3 percent to 63.8 percent. The rate for MSSP beneficiaries increased from 32.5 percent to 43.1 percent.

“As a primary care provider, I understand how challenging a new protocol can be in a practice, not to mention a whole new type of visit. Our ACO’s providers have made annual wellness visits work through an impressive combination of creativity and dedication,” says Betsy Johnson, MD, president and CEO of the MaineHealth ACO. “The ACO and MaineHealth have provided training and resources, but this success really belongs to the practice managers, the medical assistants and the providers who are making annual wellness visits a priority for their Medicare patients.”

The Medicare Annual Wellness Visit - a preventive office visit for Medicare beneficiaries - was first introduced by CMS in 2011 to create reimbursable, dedicated time for primary care providers and their team members to sit down with patients and review medication lists, confirm care team members, set health goals and ensure the completion of preventive screenings and vaccinations. Unlike a typical visit, it focuses entirely on prevention and does not include a physical exam. The unique nature of the AWV slowed its acceptance early on. But now, as experience with the AWV has increased, both patients and providers have come to understand and appreciate its usefulness.

Bonnie Hellwege, a patient at Waldo County’s Arthur Jewell Community Health Center, is enthusiastic about AWVs. She says they allow “time to talk about all the things that have been on your mind. It’s more of a holistic visit where you’re looking at what’s going on now, what’s going to be down the road.”

“It helps me a lot in terms of managing a panel of patients,” says Dr. Cornelius Yetman of Pen Bay Internal Medicine. “It gives you a little bit of freedom at other appointments to know that you did the MaineHealth ACO Monthly Newsletter | September 2018 discussion about colon cancer screening or prostate cancer once a year. It’s an opportunity to do a very thorough review of everything, not just what’s on the problem list.”

From an ACO perspective, annual wellness visits show real promise. They provide an opportunity to improve documentation of chronic diseases and increase the likelihood that a patient will access screenings and preventive care. The MaineHealth ACO’s own data bear this out, revealing better health screening rates, diabetes control and blood pressure control among Medicare and Medicare Advantage beneficiaries who’ve had an annual wellness visit compared to those who haven’t.

“Annual wellness visits are a relatively new practice tool to care for patients, and providers’ utilization of this preventive office visit is still growing. I think our ACO participants are on the leading edge of that growth and that’s great for our patients,” says Betsy Johnson. “Innovation in benefit design from both our commercial payers and Medicare that create new opportunities to serve and care for patients is always an asset for patients. We applaud our ACO providers for embracing this new tool to continue to lead the way in bringing wellness visits and better coordinated care to all patients.”

Learn more about annual wellness visits at MaineHealth’s Medicare Wellness Visit web page.