Appalachian Regional Medical Associates Providing wellness to the right patient, at the right place, at the right time through the apprhs.org Medicare Annual Wellness Visit Appalachian Regional Healthcare System
Appalachian Regional Health System Who we are ARHS • Watauga Medical Center • Cannon Memorial Hospital • The Foley Center at Chestnut Ridge • Appalachian Regional Medical Associates apprhs.org Appalachian Regional Healthcare System
Appalachian Regional Health System Who we are apprhs.org Appalachian Regional Healthcare System
Appalachian Regional Health System Who we are CHESS MSSP ACO ARMA CVMG WFBH apprhs.org Appalachian Regional Healthcare System
Why we Moved to Value Culture: Community and future focused Mission: To support the provision of high quality, compassionate healthcare for the mountain region of northwest North Carolina, northeast Tennessee with a spirit of teamwork based on a set of operating values. Vision: Build a regional healthcare system that results in healthier individuals and enhanced quality of life. Values: Compassion, Integrity and Excellence apprhs.org Appalachian Regional Healthcare System
Why we Moved to Value Past projects • Wellness Center – Thrive Program • App Faith Network • Orthopedic bundles • Service Lines • Health Navigation Grant – CMH • ACO with transformation projects like the Medicare Wellness Clinic apprhs.org Appalachian Regional Healthcare System
Why we Moved to Value Current/future projects • Medical Outpatient building - Continued focus on site of service • ASU - Health Sciences Collaboration • Wellness District • Expansion of value-based contracts apprhs.org Appalachian Regional Healthcare System
Medicare Wellness Visit Model An ACO Critical Success Factor • Attribution • Well Patients • Works in both words (fee-for service and value) • Focus on prevention improves quality performance • Can be used to “tee up” the patient HCC coding Community resources Enrollment in health navigation apprhs.org Appalachian Regional Healthcare System
Historic Challenges to Success 1. Challenges • Requirements vary and are complicated • Documentation is detailed and EHRs not optimal 2. Time intensive 3. Patients do not understand the visit • Free visit vs. split billing • No Physical exam required 4. Providers • Most providers come to the conclusion that these visits are not worth the time and effort given the complexity and the patient misunderstanding that leads to billing complaints and overall patient dissatisfaction. • Many provider attempts do not pass coding audits apprhs.org Appalachian Regional Healthcare System
ARMA Medicare Wellness Clinic • Staffing • Working at multiple sites • Documentation • Scheduling patients visit • Visit Optimization apprhs.org Appalachian Regional Healthcare System
ARMA MAWV Workflow apprhs.org Appalachian Regional Healthcare System
Volume by Fiscal Year 2015 • 338 Medicare Wellness Visits completed • $59,000 in charges 2016 (clinic started in June) • 550 Medicare Wellness Visits completed • $104,000 in charges 2017 (First Quarter) • 200 Medicare Wellness Visits Completed • $56,000 in charges apprhs.org Appalachian Regional Healthcare System
2017 Goals • Working to increase appointments • Increase PCP site referrals • Increased provider awareness/engagement • Empower staff • SNF • Hire second provider • Pharmacist? Home Visit Program? apprhs.org Appalachian Regional Healthcare System
Challenges • Scheduling • Staffing • Unified approach for quality across sites • Work to the top of the license – protocols • Patient Engagement • Pulling data apprhs.org Appalachian Regional Healthcare System
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