Increasing Performance of "Welcome to Medicare" Examinations in Rural Kansas

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DeWitt, Andrew
Orrison, Andrea
Washburn University
School of Nursing
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Initial Physical Preventative Exams (IPPEs ), also known as "Welcome to Medicare" Examinations, are significantly underutilized in the United States despite being an available benefit for Medicare beneficiaries during the first 12-months of Medicare Part B enrollment. Despite increased IPPE coverage by Medicare within the initial 12-month enrollment period, as well as changes from the Affordable Care Act in 2011, IPPEs are not routinely performed. The purpose of this Quality Improvement (QI) project was to investigate the underutilization of Medicare's IPPEs visits. A Plan-Do-Study-Act (PDSA) Cycle method was used to implement and evaluate change processes at two rural primary care clinical sites, both within the same health care system in northeast Kansas. Interdisciplinary staff members were recruited via purposive, convenience sampling from each clinic. Staff from information technology, nursing, reception, and provider staff were included in focus group sessions. Subsequent qualitative methods were used to analyze data themes. Based on identified recmTing themes verified by a professional peer review, an implementation plan was developed with specific intervention strategies. Initial recommendations were provided and a PDSA cycle timeline was established to guide participants. Qualitative data acquisition was utilized to interpret and report final data findings. Results indicate a need for establishing an internal review process to solidify sustainable implementation of this preventive screening. Additional needs include purposeful education of patients and staff to promote participation in Welcome to Medicare visits, as well as critical analysis of the financial implications associated with performing these visits.