Appalachian Regional Medical Associates Providing wellness to the - - PowerPoint PPT Presentation

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Appalachian Regional Healthcare System

Appalachian Regional Medical Associates

Providing wellness to the right patient, at the right place, at the right time through the Medicare Annual Wellness Visit

apprhs.org

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

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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

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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

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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

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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

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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

• verall patient dissatisfaction.
• Many provider attempts do not pass coding audits

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Appalachian Regional Healthcare System

ARMA Medicare Wellness Clinic

• Staffing
• Working at multiple sites
• Documentation
• Scheduling patients visit
• Visit Optimization

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Appalachian Regional Healthcare System

ARMA MAWV Workflow

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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

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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?

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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