In this episode, Dr. Dan Mingle explains how to qualify for Group Reporting and shares some insight into the differences between Annual Wellness Visits and yearly physical examinations.
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Question One: Group Reporting
John asks: “How do you qualify for Group Reporting? Does your practice have to be a certain size?”
- The Group Reporting option was once called the Group Practice Reporting Option (GPRO). It was introduced in 2013 for use in the Physician Quality Reporting System (PQRS) and is now an option in MIPS.
- You qualify for Group Reporting by being a group – there are no size restrictions.
- A group is defined as more than one provider connected by a Tax ID Number (TIN) that submits bills and collects payments.
- There are some minor variations to be aware of:
- You can be a virtual group where multiple Tax ID Numbers can come together for Group Reporting.
- Some Alternative Payment Models have variations where groups are defined by location, not only by Tax ID Number.
Question Two: Annual Wellness Visits vs. Yearly Physical Examinations
Gene asks: “Is an Annual Wellness Visit (AWV) just a yearly physical exam?”
- While you may see “annual physical” used to describe the process in popular vernacular, the two are not equivalent.
- There are three pillars of an Annual Wellness Visit:
- The Health Risk Assessment
- An indicated physical exam
- And the Health Management Plan
- The purpose of the Annual Wellness Visit is to identify and bring to the patient awareness any and all threats to their health.
- And how you, as the provider, propose managing those threats to the patient’s health.
- The Annual Wellness Visit is the perfect time to ensure that all EHR lists are accurate. Compare the problem list to the patient’s recollection, and update medication lists, allergy lists, social history, and family history.
- The Health Management Plan allows the patient and provider to agree on a comprehensive management plan.
- This is the time to explain treatment options and recommended tests to get on the same page with your patient.
- A goal in value-based healthcare is to systematize the plan of care to have this meeting between provider and patient to ensure you’re on the same page about a management plan with a system in place to take care of the day-by-day details.
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If you’d like to ask a question about the APP transition, MIPS, Primary Care First, ACO quality reporting, or any other Alternative Payment Model, you can reach out to us in three ways:
- You can leave your questions in a YouTube comment under any episode of Ask Dr. Mingle.
- On LinkedIn, leave your questions in a comment on any of our posts.
- And you can reach out directly by sending an email to firstname.lastname@example.org.
Dr. Dan Mingle and members of the team share their insights on how to maximize your success and payments for MIPS and APMs.