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- Page navigation anchor for RE: Rozehnal and Wallace Comments; Use of Wellness Visits for Primary Care AttributionRE: Rozehnal and Wallace Comments; Use of Wellness Visits for Primary Care Attribution
In response to the inquiry by Mr. Rozehnal and Dr. Wallace’s comments, thank you for reading and engaging! We apologize for the tardy response. We used a wellness visit approach for this analysis as it is unique to, but not ubiquitous for, primary care. We identified many family physicians who coded for well over the 10 count of wellness visits annually. However, some family medicine physicians coded no wellness visits in a year - so wellness visits are likely imperfect, but acted here as a surrogate marker for primary care until a more complex and comprehensive set of codes could be distilled that capture the true nature of family medicine.
As for the count of 10 wellness visits, we found a similar cohort of results with 10% of visits versus 10 numeric visits – and we hoped to be inclusive of all primary care clinicians, even those with few wellness visits. Population density did not have a significant impact on the numeric count of 10 – primary care physicians practicing in rural areas followed the trend of at least 10 wellness visits if any were coded at all.
We recognize your question address the concept that care provided in rural communities may not be eidetic to that in urban communities, so the same rules may not be followed in these areas. We agree! There is likely a combination of CPT/ICD-10 codes and/or E&M codes that best describe your typical family physician in various settings, including rural, academic, or urgent care. Figuring out thes...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: Using State All-Payer Claims Data to Identify the Active Primary Care Workforce: A Novel Study in VirginiaRE: Using State All-Payer Claims Data to Identify the Active Primary Care Workforce: A Novel Study in Virginia
As an aspiring healthcare professional, I found your work using the National Plan and Provider
Enumeration System and All-Payer Claims Database to identify the active primary care Virginia
workforce to be significant. Your approach of identifying active primary care physicians was
comprehensive. Using the 10-wellness visit threshold in addition to clinicians who had a
National Uniform Claim Committee taxonomy of family medicine to estimate the active Virginia
primary care workforce is an innovative approach. I believe using wellness visits to be an
effective and representative way to identify physicians providing primary care. Do you think
the 10-wellness visit threshold should be adjusted to reflect and/or correlate with population
density? Additionally, Virginia has a fair amount of both urban and rural communities. Would
this model be accurate if the rural to urban ratio was increased or decreased? Thank you for
clearly describing your methodology to further define and refine the active primary care
workforce in Virginia.Competing Interests: None declared.