Woodburn proactive outreach helps Medicare patients make the most of benefits
In 2024, the Salem Health Medical Clinic – Woodburn primary care team connected with close to 400 patients who missed their annual wellness visits that year.
Clinic manager Melody Molina said her team identified Medicare patients who did not have documented wellness visits in their MyChart records, and scheduling staff connected with those who needed to make appointments.
Catching patients who missed care
Woodburn successfully scheduled 158 wellness visits, with plans to schedule 125 more in 2025.
These once-a-year appointments are an important opportunity to perform preventive cognitive and cancer screenings, which are covered 100% by Medicare.
“It closes a bunch of health maintenance gaps,” Molina said. “We can get patients in for additional appointments for vaccines or mammogram screenings, just depending on the care gaps we find during the annual wellness exam. We can take care of scheduling any follow-up visits they need.”
Because of this scheduling effort, more vulnerable patients are getting vaccines for respiratory syncytial virus ( RSV), COVID-19 and whooping cough.
Previously, there wasn’t a way to catch patients who never scheduled these kinds of appointments, Molina added. Now the goal is to more proactively help busy patients keep up with preventive care.
“A lot of patients on a fixed income don’t realize there is no out-of-pocket cost for some kinds of Medicare appointments,” she said. “We want to help seniors who have been avoiding care because of cost concerns to make the most of their coverage.”
This initiative stemmed from partnerships with the Oregon Office of Rural Health and OHSU to address gaps in dementia screenings. Outreach began in October.
Looking to the future
“Moving forward, this system is what we’re going to be using to get all of those patients the care they’re entitled to,” Molina said. “Even though our medical record software is smart, it wasn’t flagging the overdue patients that needed to be seen.”