Unclaimed Annual Wellness Dollars

Recent Article Review From MedPage Today: January 1st 2011 primary care providers celebrated the victory of better Medicare payments with the introduction of 3 new billing codes! The codes were to encompass Medicare Part B beneficiaries and represented 33 M people, all who were going to have free access to “annual wellness” by their provider. Every beneficiary was given the opportunity to spend valuable time with a healthcare professional to discuss their history, review screenings, immunizations, cognitive and physical abilities, risk for falls, and needed tests or screenings like mammograms and colonoscopies.  The patient would receive extra time and attention around their health and be provided a personalized prevention plan or an “action plan”. Not to mention this program represents billions of dollars that patients couldn’t bill for previously. Patient engagement, participation and action coupled with revenue for primary care doctors seemed like a very positive equation. However, due to physician bandwidth and patient awareness, less than 20% of recipients have participated as late as 2018. While the numbers are slowly rising, it’s obvious that physicians need help in getting these valuable visits done. While the incentives are great between collecting needed quality measures, traditional reimbursement, and most importantly having a healthier patient population, physicians should consider outsourcing components of this wonderful opportunity. Whether it’s licensing software or hiring a patient engagement team, thousands of PCP have found their way and have seen their patient utilization climb north of 80%.

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