Impact of establishing a Geriatrics Workforce Enhancement Program clinic on preventive health and Medicare Annual Wellness Visits

ABSTRACT

We established a Geriatrics Workforce Enhancement Program (GWEP) clinic to enhance resident training on comprehensive preventive care and chronic disease management, and to increase the number of older patients who received Medicare Annual Wellness Visit (AWV) preventive services. A total of 1,104 patients were tracked at baseline and during the intervention period. Patients were grouped into two categories: Adult (aged 55–64) and Senior (aged 65+). Clinical quality measures were monitored by electronic health record and tracked through monthly reports at baseline (May 2018) and during the intervention period (July 2018-June 2019). In the Senior group, the proportion of patients receiving the Medicare AWV increased after GWEP began (p <.001). Additionally, the Senior group showed significant improvements in the frequency of body mass index assessments (p = .04), colorectal cancer screenings (p < .001), advance directive documentation (p < .001), cognitive screenings (p < .001), and pneumococcal vaccinations (p < .001). In the Adult group, a trending increase was seen in influenza vaccinations (p = .06). Curricular innovations including the establishment of a GWEP clinic in our residency outpatient center, development of new educational materials, and use of a nurse coordinator resulted in significant improvements in the percentage of older adults who received the Medicare AWV benefit and preventive health performance metrics.

KEYWORDS:

• Medicare annual wellness visit
• preventative health

Acknowledgments

The authors would like to thank Dr. Julia Jenkins and Dr. Jeffrey Sourbeer at the USF-MPM Family Medicine Residency for their service as teaching faculty in the GWEP clinic; faculty, residents, staff, and students at TFHC for participating in this initiative; and Laura Hinderliter-Zamora, Sarah Dumolt, Brian Barkauskas, and Chirag Patel at Baycare Health System Information Support for their hard work and dedication to constructing the GWEP Dashboard and collecting and organizing the data, without which this project would not have been possible.

Disclosure statement

All authors report no known conflicts of interest.

IRB approval number

#2018.058-BMP

Data availability

The data that support the findings of this study are available on request from the corresponding author, CH. The data are not publicly available due to their containing information that could compromise the privacy of research participants.

Additional information

Funding

This work was supported in part by funds from the U.S. Department of Health and Human Services (HHS), Bureau of Health Professions (BHPr), Health Resources and Services Administration (HRSA): [U1QHP28739].