u/Fragrant_Shift5318

I hate these . Looking to see if we can streamline. Do yall do the following and if not is it not required? Tired of the mountains of paper

1. Health risk assessment completed by patient in waiting room
2. Geriatric depression scale done by patient
3. Cage questions check box
4. Social determinants of health form, more checkboxes done by patient , I’m told some insurance is not this and I guess for positive responses we are supposed to send them to a nurse
5. Preventative service guide completed often prior to visit by MA . I never look at this because our EMR has a separate quality measure section.(Atheena)
6. Ma rooms , does weight blood pressure vitals. They then administer the mini cog test (clock draw). They are supposed to do vision but most of them just document they have an eye doctor if they see them wearing glasses. They’re supposed to do hearing but no one does it. They just assume if the patient can hear them that they pass. So we’re documenting hearing screenings that really are not being done.
7. As a new feature, the MA is supposed to ask them about rectal incontinence specifically like frequency of gas stool liquid stool, etc. There’s also a check box form, but it’s extremely confusing people think asking about their bowel habits not whether or not they have incontinence they check the box for solid stool every day but it means “do they have incontinence every day”
8. All of the patient responses are then stapled together in a big packet and handed to the physician to review. We are expected to sign every single page of this every time. Gets scanned in.
9. Physician goes in and does their thing. We are supposed to talk about advanced care planning, but I really don’t have time for that every year I focus on that at initial visit and as needed after .
   Our patients do complete labs before the visit. We have very low uptake when it was just the required Medicare annual wellness elements as who really wants to come in and just answer questions.?

Just wondering if we’re doing too much… I’m asking the rectal incontinence screening be removed. It’s not part of the requirements.

OK, so I know we all hate Medicare advantage for obvious reasons but honestly every time I have a patient with straight Medicare plus a supplement every time I wanna prescribe anything that is not generic including pretty important stuff like Eliquis, entresto, symbicort, they can’t afford it. Explained to them that the initial price is the 600 deductible +25% of the cost and it will go down . I explained once they reached the $2100 out-of-pocket maximum they will be covered. I know about the Medicare payment plans and offer info sheet on it but it seems like they just cannot afford anything. I have a patient right now that I cannot find an inhaler with a laba steroid that’s an affordable. I’m so frustrated and it seems like when people ask me about Medicare vs Medicare advantage I don’t know what to say because I know Medicare advantage sucks but time and again this issue comes up with affording drugs. Multiple people they go and get their drugs from Canada online. How is this really better than Medicare advantage?