• Center on Health Equity and Access
  • Clinical
  • Health Care Cost
  • Health Care Delivery
  • Insurance
  • Policy
  • Technology
  • Value-Based Care

AJMC Commentary: U.S. Needs Evidence-Based Guidelines for Scheduling Follow-up Doctors' Visits


Are Doctors' Visits Set by Evidence or Habit? Extending Follow-ups Could Save Billions, Authors Say


AJMC Commentary: U.S. Needs Evidence-Based Guidelines for Scheduling Follow-up Doctors’ Visits

Are Visits Set By Need or By Habit? Extending Follow-ups Could Save Billions, Authors Say

PLAINSBORO, N.J. — The time has come for evidence-based guidelines for scheduling follow-up visits with doctors, a change that could trim billions from health care costs, according to the authors of a commentary published this month in The American Journal of Managed Care.

Despite nearly 1 billion annual outpatient follow-up visits in the United States, there’s not much data documenting the evidence base for follow-up intervals for costly chronic conditions. The current commentary seeks to establish follow-up intervals to reduce healthcare costs and improve access.

Considering that a major portion of outpatient office visits are follow-ups, the study considered the following questions: Are the visits and their time frames determined scientifically or by convenience and habit? Is there evidence to support a physicians practice patterns? And, if there is evidence to support practice patterns, do physicians adhere to the guidelines?

“Evidence-Based Guidelines to Determine Follow-up Intervals: A Call for Action,” by Emilia Javorsky, MPH; Amanda Robinson, MD; and Alexa Boer Kimball, MD, MP, followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines along with a PubMed database search for relevant studies for the top five chronic conditions with the highest outpatient visits in 2010 (mental disorders, back problems, arthritis, chronic obstructive pulmonary disease/asthma, hypertension), which cost an estimated $281 billion. For the full commentary, click here.

The authors modeled hypertension, which accounted for $47.4 billion in overall expenditure, and $13.03 billion in outpatient visits. Using the Medicare national allowable billing amount of $65.30 (Current Procedural Terminology code 99213 visit), they determined that an extension of the follow-up visit from six to seven months would result in a 15 percent decrease in visits per year, saving nearly $682 million. An extension to nine months would trim visits 34 percent, saving $1.5 billion, while an extension to annual visits would reduce visits by half and save $2.3 billion. The authors also predicted accurate blood pressure assessment and therapy adjustments.

Thus, the study concluded that evidence-based follow-up intervals must be established on healthcare outcomes to help reduce healthcare costs per person and improve access without compromising or restricting care.

CONTACT: Nicole Beagin or Mary Caffrey (609) 716-7777 x 131 or x 144

nbeagin@ajmc.com mcaffrey@ajmc.com

www.ajmc.com Follow us on Twitter @AJMC_Journal

Related Videos
Ian Neeland, MD
Chase D. Hendrickson, MD, MPH
Steven Coca, MD, MS, Icahn School of Medicine, Mount Sinai
Matthew Crowley, MD, MHS, associate professor of medicine, Duke University School of Medicine.
Susan Spratt, MD, senior medical director, Duke Population Health Management Office, associate professor of medicine, division of Endocrinology, Metabolism, and Nutrition,
Stephen Nicholls, MD, Monash University and Victorian Heart Hospital
Amal Agarwal, DO, MBA
Dr Robert Groves
Dr Robert Groves
Related Content
© 2024 MJH Life Sciences
All rights reserved.