Work

Implementing Change in Primary Care Through the Annual Wellness Visit: On-site Support Vs. Learning Collaborative

Year: 2018

Type: article

Abstract: The Dartmouth Centers for Health and Aging Health Resources and Services Administration (HRSA) Geriatric Workforce Enhancement Program (GWEP) led a yearlong implementation to transform primary care around best geriatric practice. In addition to improving patient outcomes, the objective was to increase practice efficiency and revenue. We implemented the Geriatric Interprofessional Team Transformation in Primary Care (GITT-PC) model in rural primary care practices by leveraging Medicare reimbursements through the following billable codes: Annual Wellness Visit (AWV), Chronic Care Management (CCM), Advance Care Planning (ACP), and Dementia Codes. The implementation included face to face in-person trainings focusing on Team Training “Teaming Up”, “Quality Improvement 101” and 4 training and implementation bootcamps focusing on each of the four Medicare codes. Two implementation strategies including (1) on-site elbow to elbow coaching (n=3) and (2) virtual learning collaborative (n=3) were tested. At the end of the implementation plan, more AWVs were billed by the virtual learning collaborative practices than by practices receiving on-site coaching (120.4 ± 25.7 vs. 27.2 ± 3.5; p<0.001). The learning collaborative group outperformed the on-site coaching group. Based on the total number of AWVs billed through the implementation period and ease of resources from the implementation team, the virtual learning collaborative model appears to be the more effective means of providing implementation support to rural primary care practices.

Source: Innovation in Aging

DOI: 10.1093/geroni/igy023.528