Even before the Affordable Care Act of 2010 provided yearly wellness visits at no cost for Medicare
patients, Shashi Saigal, M.D., was a big believer in the value of preventive (prevention) medicine.
“All my life, I’ve been a very pro – preventive medicine person because you can catch a lot of problems before patients know about them,” says Dr. Saigal, an Alexian Brothers Medical Group family physician and a member of the Alexian Brothers Accountable Care Organization (ABACO).
A practicing physician for nearly 30 years, Dr. Saigal estimates that Medicare patients now account for a third of her patients. “My patients are growing older with me,” she says. They also share her belief in preventive medicine. “I have almost 100 percent of my patients coming back for annual wellness visits,” she says. The visits are designed to help patients and their physician develop a personalized plan for staying healthy and preventing disease and disability.
The visits are a key element in the Affordable Care Act’s focus on preventive care and in ABACO’s efforts to enhance the quality of care provided to Medicare patients, while also reducing the cost of care.
During these visits, the patient completes a health risk assessment, and the physician reviews and updates (if necessary) the patient’s and his or her family’s medical history and the patient’s current providers and prescriptions. Routine measurements, such as height, weight and blood pressure, are taken, and the physician watches for any signs of cognitive impairment. The physician also offers personalized advice and provides a list of risk factors and treatment options as well as a screening schedule for appropriate preventive services.
Dr. Saigal says the visits provide an important opportunity to talk with patients about multiple issues, to remind them of the need to catch up on certain tests or vaccinations, and to educate them. She says she often includes blood and urine tests and electrocardiograms during wellness visits, because Medicare covers them at no cost to patients. “Medicare is very generous with their annual well visit,” she says.
The visits usually take 30 to 45 minutes, “but it’s worth it,” Dr. Saigal says. In many cases, the visits have prevented heart attacks or led to the early detection of colon cancer or diabetes, Dr. Saigal says. She cites the visits as a key factor in her patients’ low hospitalization rate. During a recent 12-month period in which she had 4,600 patient appointments, fewer than 20 of her patients were hospitalized. “That is my biggest success,” Dr. Saigal says.
When longer wellness visits extend her workday, she voluntarily works additional hours to accommodate her patients. “I want to do it because I think it’s the right thing to do,” she says.