Outcomes of A Virtual Practice-Tailored Medicare Annual Wellness Visit Intervention.


Journal

Journal of the American Board of Family Medicine : JABFM
ISSN: 1558-7118
Titre abrégé: J Am Board Fam Med
Pays: United States
ID NLM: 101256526

Informations de publication

Date de publication:
08 May 2023
Historique:
received: 28 09 2022
revised: 03 01 2023
accepted: 09 01 2023
medline: 12 6 2023
pubmed: 8 4 2023
entrez: 7 4 2023
Statut: ppublish

Résumé

Interventions are needed to promote utilization of the Medicare Annual Wellness Visit (AWV), an underused opportunity to perform screenings and plan individualized preventive health services. Using remote practice redesign and electronic health record (EHR) support, we implemented the Practice-Tailored AWV intervention in 2021 (during the COVID-19 pandemic) in 3 small community-based practices. The intervention combines EHR-based tools with practice redesign approaches and resources. Outcomes included completion of AWV and fulfillment of recommended preventive services. At baseline the 3 practices had 1,513 Medicare patients with at least 1 visit in the past 12 months. AWV utilization went from 7% at baseline to 54% 8 months postintervention implementation; advance care planning increased 10.7% (from 7.9% to 18.6%); depression screening increased 16.3% (from 51.7% to 68.0%); and alcohol misuse screening increased 17.3% (from 42.6% to 59.9%). Every individual preventive health service was received more often by patients with an AWV than those without. At the patient level, fulfillment of all eligible preventive services (of a maximum of 12 evaluated) went from 47.5% to 53.8% ( Virtual implementation of an intervention that combined EHR-based tools with practice redesign approaches increased AWV and preventive services utilization in Medicare patients. Given the success of this intervention during the COVID-19 pandemic (when practices had many competing demands), greater consideration should be given to delivering future interventions virtually.

Identifiants

pubmed: 37028913
pii: jabfm.2022.220342R1
doi: 10.3122/jabfm.2022.220342R1
pmc: PMC10352446
mid: NIHMS1909150
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

501-509

Subventions

Organisme : NIA NIH HHS
ID : R33 AG068946
Pays : United States
Organisme : NIA NIH HHS
ID : R61 AG068946
Pays : United States

Informations de copyright

© Copyright by the American Board of Family Medicine.

Déclaration de conflit d'intérêts

Conflict of interest: Dr. Tarn has been funded by the BMS/Pfizer Alliance ARISTA-USA to conduct unrelated research studies.

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Auteurs

Derjung M Tarn (DM)

From the Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (DMT); DARTNet Institute, Aurora, CO (WDP); Division of General Internal Medicine/Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (C-HT, NSW); American Academy of Family Physicians, Leawood, KS (EC, NYL); and Center for Community Health Integration and Department of Family Medicine & Community Health, Population & Quantitative Health Sciences, and Sociology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH dtarn@mednet.ucla.edu.

Wilson D Pace (WD)

From the Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (DMT); DARTNet Institute, Aurora, CO (WDP); Division of General Internal Medicine/Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (C-HT, NSW); American Academy of Family Physicians, Leawood, KS (EC, NYL); and Center for Community Health Integration and Department of Family Medicine & Community Health, Population & Quantitative Health Sciences, and Sociology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH.

Chi-Hong Tseng (CH)

From the Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (DMT); DARTNet Institute, Aurora, CO (WDP); Division of General Internal Medicine/Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (C-HT, NSW); American Academy of Family Physicians, Leawood, KS (EC, NYL); and Center for Community Health Integration and Department of Family Medicine & Community Health, Population & Quantitative Health Sciences, and Sociology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH.

Elisabeth Callen (E)

From the Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (DMT); DARTNet Institute, Aurora, CO (WDP); Division of General Internal Medicine/Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (C-HT, NSW); American Academy of Family Physicians, Leawood, KS (EC, NYL); and Center for Community Health Integration and Department of Family Medicine & Community Health, Population & Quantitative Health Sciences, and Sociology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH.

Natalia Y Loskutova (NY)

From the Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (DMT); DARTNet Institute, Aurora, CO (WDP); Division of General Internal Medicine/Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (C-HT, NSW); American Academy of Family Physicians, Leawood, KS (EC, NYL); and Center for Community Health Integration and Department of Family Medicine & Community Health, Population & Quantitative Health Sciences, and Sociology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH.

Kurt C Stange (KC)

From the Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (DMT); DARTNet Institute, Aurora, CO (WDP); Division of General Internal Medicine/Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (C-HT, NSW); American Academy of Family Physicians, Leawood, KS (EC, NYL); and Center for Community Health Integration and Department of Family Medicine & Community Health, Population & Quantitative Health Sciences, and Sociology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH.

Neil S Wenger (NS)

From the Department of Family Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (DMT); DARTNet Institute, Aurora, CO (WDP); Division of General Internal Medicine/Health Services Research, Department of Medicine, David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA (C-HT, NSW); American Academy of Family Physicians, Leawood, KS (EC, NYL); and Center for Community Health Integration and Department of Family Medicine & Community Health, Population & Quantitative Health Sciences, and Sociology, Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, OH.

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