How To Grow Your Practice With Group Medical Visits

Group medical visits are a growing trend in physician practices. Under this appointment model, a physician sees and consults with multiple patients in a single setting at one time. While your initial reaction may be no way don't sell the idea short. It may be a viable way to grow your practice.

Studying The Concept

There are two types of group visits. The first is the shared medical appointment (SMA) or the cooperative health clinic (CHC), in which eight to 12 patients with the same chronic condition meet with a physician in a conference room for two to three hours.

After the practice staff registers the patients, verifies their insurance coverage and takes their vital signs, the session begins with an introduction of the day topic, perhaps exercise, diet or medication. The doctor then addresses each patient individually about his or her specific condition and creates individual treatment plans and provides specific education as appropriate.

During the meeting, medical chart entries are made as though it were a series of separate private visits. And patients can ask questions about their own or others' cases.

Typically, SMAs or CHCs are held monthly or quarterly with the same group of patients. As a result of the shared intimacies, the group develops a cohesion that allows it to function much like a support group.

The second form is the drop-in group medical appointment. These meetings last half as long as an SMA or CHC, are attended by whichever patients choose to appear, and tend to address a variety of episodic or acute care conditions.

Satisfying Everyone

Group visits have the potential to satisfy everyone involved. Physician productivity increases, because they see more patients in a day and increase their primary care billings. Plus, doctors are more satisfied with their patient interactions, as group visits can be a nice departure from the usual routine.

In addition, several clinical disciplines are involved in the visits, improving coordination of care. All of this leads to fewer specialist referrals, ER visits and repeat hospital visits by group members.

From the patient standpoint, they're typically more satisfied with their physicians and trust them more because conversations are more intimate and informal. They're also supported by other group members in coping with their sicknesses and can learn from the experiences and questions of other group members. Patients will also become more knowledgeable about the disease processes affecting them, and their overall health care education will improve.

Plus, patients may likely adhere better to their medication regimens and self-care guidelines with the support of others. Although there no conclusive evidence of better clinical outcomes, they definitely don't worsen.

Be aware, however, that privacy issues can arise in a group session. Before joining, patients should be advised that personal health information may be disclosed during a group visit and asked to sign a HIPAA disclaimer acknowledging this fact.

Getting Into The Nitty-Gritty

It will likely take a few group sessions before the practice becomes comfortable with them. Your staff must learn how to:

• Explain the purpose and structure of the meetings to patients,
• Gather the same types of information from attendees as they would gather for an individual office visit, and
• Schedule the group visits regularly.

Physicians will also need to develop a new presentation style for these meetings.

A common question about group medical visits concerns billing. No third-party payors currently distinguish between group and individual visits. Plus, there no CPT code for group visits. So it generally best to bill for each patient as though he or she had been seen individually. Most of the time that means using standard evaluation and management (E/M) codes 99212 to 99215.

Some coding consultants have suggested using 99499 (unlisted evaluation and management service) and 99078 (physician educational services rendered to patients in a group setting). Make sure you check with the appropriate payors beforehand. The same documentation must be completed for components of the visit, such as vital signs, lab tests, medical history, physical examination and therapy decisions.

Exploring The Option

Group visits don't work for every practice. But don't let that stop you from exploring this intriguing new option in patient care.