Why Healthcare Brands Should Push for Annual Wellness Visits

Open enrollment tends to consume healthcare marketing teams this time of year, but there is another piece of low-hanging fruit — the Annual Wellness Visit. By increasing the completion rate of AWVs by Dec. 31, you provide a meaningful service for patients, generate revenue for physicians and potentially boost your organization’s risk-adjusted reimbursements.

Open enrollment tends to consume healthcare marketing teams this time of year, but there is another piece of low-hanging fruit — the Annual Wellness Visit (AWV). By increasing the completion rate of AWVs by Dec. 31, you provide a meaningful service for patients, generate revenue for physicians, and potentially boost your organization’s risk-adjusted reimbursements.

Anyone enrolled in Medicare for longer than 12 months qualifies for a once-a-year AWV. This is a preventive health benefit offered at no cost to the patient. The AWV is a longer format office visit between a patient and provider to complete a Health Risk Assessment (HRA), discuss health concerns and document conditions that ultimately factor into the patient’s risk score. Because the visit is not associated with a specific health complaint and request for treatment, it can be harder for a patient or provider to see its real value. That may be one reason why only 14%-19% of senior populations typically have AWVs, but it offers four notable benefits:

1. The AWV Helps the Patient and Doctor Forge a Better Relationship

These appointments take 45 minutes to an hour, longer than a typical visit. The visit is a discussion that touches on family medical history, assessment for depression or cognitive impairments, a review of specialists seen by the patient, and other items. The appointment duration and nature of the discussion fosters a relationship that reduces doctor hopping and can improve word-of-mouth referrals.

2. Patients Who Have AWVs Tend to Have Better Health Outcomes

The whole purpose of the AWV is to translate information from the HRA into a Personalized Prevention Plan, all made possible by the extended conversation time. Because the approach is a form of shared decision-making, patients are more likely to feel an obligation to try and live up to it. And, as providers document specific clinical actions needed over the coming year, completions of those quality metrics also rise.

3. Some Medicare Plans Pay a Bonus

AWV is a focus of Medicare Advantage plans, and some provide bonuses to organizations that raise AWV completions

If your organization has an easily definable base of seniors, ask your contracting department if any of your health plan partners are offering AWV incentives. In some cases, you may be able to draw on health plan funds to offset your costs in promoting the service to your qualified patients. Mailers to patients, newspaper ads, messages via your patient portal, outbound calls and targeted digital ads are all ways to drive AWV appointments that occur by the end of the year. The end-of-year ‘expiration’ can be a motivating factor for patients who seek to maximize their health benefits while others find value in starting the new year off ‘right.’

4. More Time to Code Health Risks

The AWV gives the provider more time to code appropriate health risks and conditions into your EHR system, which can increase risk-adjusted reimbursements over the coming year.

Marketers focus on new patient acquisition, which is expensive, but may overlook substantive patient engagement tactics that impact reimbursement levels. Any communications directed to providers should indicate the Evaluation and Management (E/M) service code and a link for resources on how to bill if treatment or diagnostic modifiers need to be applied.

Although open enrollment is a natural focus for this time of year, a last-minute push for AWVs or a year-round strategy for communicating this benefit to older patients can yield financial and quality results for your organization.

‘Tis the Season … for Term Letters in Healthcare

Nothing says “happy holidays” like a year-end coverage termination notice. It’s particularly awkward this time of year, because it overlaps open enrollment for commercial, Medicare Advantage and Exchange members. In this column, we’ll look at five seasonal drivers within healthcare, and how marketers can prepare for term letters, open enrollment and more.

Nothing says “happy holidays” like a year-end termination notice. It’s not unusual for healthcare organizations engaged in contract negotiations to send term letters to patients in mid-November. The notices fulfill contractual and regulatory obligations to provide advance notice to patients while also ratcheting up the pressure to reach agreement before a January 1 effective date.

This would cause headaches for marketing and communication professionals under the best of circumstances, but it’s particularly awkward this time of year because it overlaps open enrollment for commercial, Medicare Advantage and Exchange members. This is just one of the external factors that creates seasonality in healthcare communications.

In this column, we’ll look at five seasonal drivers within healthcare and how marketers can prepare.

1. Termination Letters

Term letters are usually sent 45 days in advance of a contract’s renewal or end-date. While these can occur at any time, a common scenario is a termination letter sent by a health plan about six weeks before the end of a calendar year. The letter goes to patients of physicians/medical groups or hospitals covered under the contract in question.

In some cases, you may not know the term letters have gone out until you begin to receive frantic calls from patients wondering if scheduled appointments or procedures will be covered. This puts you in a terribly reactive situation.

Proactively, marketers should schedule quarterly meetings with their organization’s contracting department to discuss commercial, exchange and governmental agreements that are coming up for renewal. Your contracting team is likely to focus on the financial framework of the agreement, while your concern should be on how to manage the fear and uncertainty a potential disruption has on individual patients.

Coordination with your customer service team, as well as impacted physician practices, are also critical because they will be on the front line of inquiries. You will need to understand your state’s Continuity of Care guidelines, the terminating plan’s grace period (if any), and work cross functionally to help guide patients to in-network facilities or providers if the agreement ends.

This is a labor-intensive, detail-oriented process because of the number of potentially impacted people, and emotionally draining for the patient’s family. Communicate your awareness of the situation, provide updates often and be prepared for significant push-back and one-on-one problem solving.

2. Open Enrollment

Although open enrollment for major employers, general business, Medicare/Medicare Advantage and Exchange business differ, the main season occurs in the fall and early winter. Some organizations invest all their awareness efforts during this time, when in fact this is when you should be converting prospects based on the awareness, goodwill and brand desirability you’ve cultivated all year long.

The foundation for a successful open enrollment season is based, in part, on decisions made by upstream parties during the spring and summer. As 2018 approaches, be sure to build in strategies to reach large employers, brokers, physicians and health plans.