Checking up: Inspira Medical Group is focusing on underutilized free wellness visits for Medicare patients

As physician groups collectively endorse a restart of routine care that might have fallen off for some patients during the pandemic, one South Jersey institution is trying to ensure patients know where to start.

One of the initiatives at Inspira Medical Group, the physician network under South Jersey’s Inspira Health, right now is the promotion of free yearly appointments for Medicare patients that better introduces medical teams to their health risks. From that appointment, known as the Medicare annual wellness visit, physicians can draw up disease management or prevention plans.

But Dr. Evelyn Balogun, chief medical officer of Inspira Medical Group, said there has been some confusion about this risk assessment option among patients. Her organization believes more could be done to correct that.

“We’ve maybe not had the messaging or communication about this (in the past),” she said. “We recently had a community benefit event focused on cardiovascular health. At the end, we introduced the idea of being up to date on your annual wellness visit. It was interesting to hear the responses from attendees, because several thought that they were either not eligible or there was a copay attributed to the care.”

Foundational in the messaging they’re trying to convey is these preventative health check-ups are — with just a few stipulations — a covered benefit under Medicare, Balogun said. Among other things, patients detail their medical history during these appointments, update medical teams on their prescriptions, health metrics such as blood pressure and are screened for cognitive impairments.

These visits were introduced more than a decade ago to bolster preventative care, especially for an aging patient population. But a review published in the medical journal Health Affairs five years ago found that less than 20% of eligible beneficiaries participated in these visits.

Balogun said the uptake still could be improved today, which is why her physician group has made this a major focus. She adds that it’s important to establish a baseline with patients, particularly for the management of chronic conditions such as diabetes and cardiovascular problems — anything that’s considered a precursor to more complicated care needs in the future.

“For quality and a cost factor (in the health care space), the ideal premise is to prevent disease and illness before a patient or Medicare participant needs either an urgent care or an emergency room,” she said.

Along with making an intentional marketing push to encourage more annual wellness visits, Inspira Medical Group is trying to overcome some of the barriers faced by patients.

“One of them is transportation,” Dr. Balogun said. “Telehealth presents an opportunity there, because an in-office exam is not needed as part of the assessment. It’s an encounter that’s amenable to a telehealth virtual visit. By allowing people to do this from the comfort of their own home … at a time that’s conducive to their schedule, we can reach more patients.”

As for what Inspira has been able to achieve from what Balogun describes as a largely nurse-led initiative, it’s seen “a tremendous amount of success.”

“If we were to look at the number of people we’re able to try to engage from a scheduling standpoint from the first quarter, we’ve had a marked increase in the number of patients we’re able to make contact with in comparison to the first quarter of the past two calendar years,” she said. “Of course, scheduling is just the beginning of the process … but we’re excited about that.”