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Group Appointments: A new niche for Primary Care Practice

Group appointment, also referred to as shared medical appointment, includes multiple patients seen as a group for follow-up or routine care. These visits are voluntary for patients and provide a secure but interactive setting in which patients have:

  • improved access to their physicians,
  • the benefit of counseling with additional members of a health care team (such as a behaviorist, nutritionist, or health educator), and
  • share experiences and advice with one another.

According to the AAFP, Group Appointments were utilized by around 6% of family physicians to provide some amount of patient care in 2005, and that number has gone up to 13% in 2010. Group medical appointments are also a key component of the patient-centered medical home (PCMH) model. There are three general models for the shared medical appointment:

  • The cooperative health care clinic (CHCC), created for older patients requiring frequent, broad-spectrum care;
  • The disease-specific CHCC, a diagnostically exclusive group that aids patients with chronic-disease management; and
  • The drop-in group medical appointment (DIGMA), intended for established patients requiring a more comprehensive approach to their follow-up care.

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Medicare generally pays for group visits if there is some one-on-one time with the physician, but practices should contact local carriers and other insurers about their policies; some carriers are still resistant to the idea.

Who benefits from this type of program?

Shared medical appointments can be satisfying to both the physician and the patient, used as substitution or in addition to a traditional appointment. They are most appropriate for patients requiring routine follow-up care, or frequent time with the physician, or chronic patients. They can offer an increase in the productivity and efficiency of the health care team as well as enhance the patient’s visit by offering a holistic and therapeutic approach.

Staff

Group appointments might require trained staff to act as facilitators, or even especially experienced billers and coders who are able to understand the process of group appointments, in order to get proper reimbursement for the providers, although physicians can outsource billing assistance for such appointments to professionals who are trained and experienced in group practice billing.

FAQs

1. What are group appointments in healthcare?

Group appointments, also known as shared medical appointments, involve multiple patients meeting with a physician or healthcare team simultaneously for follow-up or routine care. These sessions are voluntary and allow patients to access their physician, receive counseling from additional healthcare team members, and share experiences with other patients in a supportive environment.

2. What types of group appointments are there?

The three main models for shared medical appointments are:

  • Cooperative Health Care Clinics (CHCCs): Focused on older patients requiring broad-spectrum care.
  • Disease-Specific CHCCs: Designed for patients managing chronic conditions.
  • Drop-In Group Medical Appointments (DIGMAs): For established patients needing comprehensive follow-up care.

3. Does Medicare cover group medical appointments?

Medicare typically reimburses for group visits if there is individual one-on-one time with the physician. However, coverage policies can vary, so it’s essential to verify with local Medicare carriers and other insurers, as some may not fully support group appointments.

4. Who benefits most from group medical appointments?

Group appointments are particularly beneficial for:

  • Patients needing routine follow-up care.
  • Individuals requiring frequent interaction with a physician.
  • Patients managing chronic conditions.
    These appointments enhance healthcare team efficiency and provide a holistic, therapeutic patient experience.

5. Why is specialized billing important for group appointments?

Billing for group appointments can be complex and may require specialized expertise to ensure accurate reimbursement. Practices often rely on trained billers or outsource to professionals experienced in group practice billing to navigate unique documentation and coding requirements effectively.

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