25 Jun Well Visit Recalls: Are You Optimizing Care and Payment?

Preventative care is the cornerstone of pediatrics, yet many practices don’t optimize their well visits. If you are not doing proactive recalls, you are leaving money on the table and your patients are not receiving optimal care. There are several aspects to optimize well visits but your practice must be committed to doing this on a regular basis.

Where to start? Be reactive within the office. Every time a patient’s chart is touched (triage nurse, vaccine-only visit, form request, sick visit), train your entire team to look for the red date, indicating the patient is overdue for a well visit. Encourage them to check siblings as well.

There’s no time like the present. Alter your practice thinking to turn a sick visit into a well visit at every opportunity. Build your schedule so you have time to do this. There are several ways to approach it, wave scheduling, a “booked lighter” provider which absorbs these as well as provides a cushion for your practice, or book a “50 minute hour” for all your providers and use that to absorb the unanticipated (patient sicker than was anticipated, tag-a-long, or sick that is overdue for a well.) During your practice “morning huddle,” look through the schedule and identify those patients who are scheduled for sick visits that don’t have a well scheduled and are overdue. Create a contest in your office that the staff member that turns the most sick into a well in one week gets a gift card. (If your staff get really good about the first action, recognizing the red dates when they touch the chart, this happens much less!)

Determine how large your “overdue for well visits” population is. This is easily run using the Demographic Analysis and Recall (DAR). If it’s huge and you are thinking, “but we don’t have room in the schedule to see all of those patients!” then decide on a catch-up strategy. You would like to build this in over the course of the year so you aren’t always trying to fit in every school-aged child’s well visit in the summer when half of your providers are on vacation. Maybe you start with a particular insurance that is your highest payer or will give you a pay-for-performance bonus for improving adolescent well visits. Identify a subpopulation and get them scheduled, then widen your outreach.

You have to be willing to meet your families where they are. It’s often not their highest priority to get a well visit when they are holding down 2 jobs and trying to put food on the table. That may mean you need to offer early morning check ups, after school check-ups, or mark your school holidays in your calendar and proactively schedule more time. Some practices offer “same day walk-in” check ups between 12:30-2:30 PM when the office tends to be naturally slower.

Anticipate “crunch times.” They are predictable. Will your middle school and high school athletes need a sports form filled out within the first week of school to play? Proactively use recalls and social media now to invite those patients to come in for their well visit and you will fill out their form free of charge! (That’s higher value than going to the Minute Clinic, since well visits are for the most part, without family copayment responsibility.)

Your office team should be recalling kids for well visits and least monthly, but they need protected time to do this work. Start with running the DAR the first week of the month and sending a generic reminder message using the patient message eXchange. Then 2 weeks later run again and have your staff send portal messages or text reminders to those who haven’t scheduled. Continue to follow-up until they are on the forward calendar.

Once you have a well-oiled machine, take advantage of the fact that you can run this recall for months ahead! As soon as you open up your schedule for October, use the DAR and identify any patient who will be due between now and the end of October and send them a message asking them to contact the office to schedule their appointment so they can get it on their calendar. If you run these recalls all year long, the well visits can be spread out over the course of the year so there is less summer and end of year check-up crunch.

When all your patients are up to date with well visits, everyone wins. They get great care. You get paid well. You often qualify for P4P bonus monies and sometimes you can use your awesome rates as leverage to negotiate improved payment from your payers!

What are you waiting for?