QI Project Summary

What is the problem?

Medicare patients are often chronically ill and do not receive preventative care services such as vaccines and colon cancer screening. Medicare patients are not aware that Medicare pays for them to have a “Medicare Annual Wellness Visit,” whose entire purpose is to provide education about preventative care options and make a customized plan for the next 10 years. Federally Qualified Health Centers are often not aware that they can receive 130% of their encounter rate for each patient who receives a Medicare Wellness Visit. Family medicine residents are often not taught to lead group medical visits during residency.

What did you do?

Dr. Powers created the concept of “Group Medicare Wellness Visits” for patients with Medicare insurance, led by family physicians or R3 family medicine residents. Approximately 18 family medicine residents were trained to conduct group medical visits and 2 residents each led 1 group visit supervised by Dr. Powers. Forty patients participated in Group Annual Wellness visits, which consisted of a vital sign check, vision screen, fall risk screening, clock drawing test, depression screening, and group education regarding preventative care topics such a fall prevention, colon cancer screening options, vaccines, breast cancer screening, glaucoma, osteoporosis screening, and AAA screening. Patients were offered immediate vaccination and asked to make a decision regarding their preventative care options. They then received a 5 minute, one on one encounter with the physician and review of their clock drawing test, depression screening, and fall risk assessment in private.

What were your metrics?

We looked at the percentage of Ellensburg clinic patients 65 or older who received yearly mammography, colon cancer screening, and pneumococcal vaccination.

What did you find?

We found Medicare patients who participated in group Medicare Annual Wellness visits were much more likely to receive preventative services such as mammography (53% vs 23%), pneumococcal vaccination (92% vs 69%) and colon cancer screening (61% vs 74%) than those who did not participate in group Medicare Annual Wellness visits.

About the QI Project Leads:

Dr. Micahlyn Powers is junior faculty at Central Washington Family Medicine residency’s rural track in Ellensburg, WA. She is clinical site director at CHCW-Ellensburg and a family physician providing full-spectrum care including OB in rural Washington.

Keywords:

geriatrics, Medicare Wellness Visit, Annual Wellness Visit, preventative care, group visit