Group Visits for Diabetes
(this is part of the DMCP training)

Group visits are a unique way to help patients reach their goals. National data indicate that 45 to 60% of Diabetic Patients are not at ADA goal for A1C of  <7, LDL of <100 and B/P of 130/80. The DMCP registry confirms these
numbers for several of the practices.

There  are several ways that group visits can be conducted and if documented correctly codes for E/M visits like 99213 and 99214 can be used. Group visits
can be utilized for many problems in primary care-e.g. COPD, Asthma, Obesity,
and Smoking.

Charging for Group Visits from AAFP Web site 

CMS responded to a letter about charging for group visits saying , "...under existing CPT codes and Medicare rules, a  physician could furnish a medically necessary face-to-face E/M visit (CPT code 99213 or similar code depending on level of complexity) to a patient that is  observed by other patients. From  a  payment perspective, there is no prohibition on group members observing while a
physician provides a service to another  beneficiary."

Several articles are available in the next column to help you understand group visits.

Articles about Group Visits

The DMCP group visit training manual was developed to  provide you and your staff a pragmatic to do list for group visits. The other articles represent views of different authors about group visits and some of the evidence about the effectiveness of group visits in primary care (click on the word here or the words in blue  to download the article.   

Click click here for DMCP Group Visit training manual.  Good overview of group visits, how to document and charge for the group visit. 

David Roll MD Group visits and opiod addiction--This study examines patient experiences with shared medical appointments for buprenorphine treatment at a safety net primary care clinic.

Leonie Heyworth, MD Group visits and patient satisfaction--patients appear more satisfied with their care relative to patients receiving usual care. 

Sharon A. Watts, FNP DNP, Group visits Diabetes and reduced A1C   

Susan Riley FNP DNP Study of group visit impact on diabetes Quality Numbers in one practice Journal
of the American Academy of Nurse Practitioners 2012;
00 1–7

AIM HIGH users manual. AAFP info on group visits. 
 
Trento MA et al Rethink Organization to iMprove Education and Outcomes (ROMEO)  A multicenter randomized trial of lifestyle intervention by group care to manage type 2 diabetes, Diabetes Care 33:745–747, 2010  
   
Davis A et al The  Potential of Group Visits in Diabetes Care Clinical Diabetes ;2008 26:58-62 .     

Shahady  E, Group Visits for Diabetes: An Innovative Way to Overcome Barriers and Achieve Quality Care, Consultant 2010;  50:480-486

Burke and O'Grady Group Visits hold great potential for improving diabetes care and outcomes, but best practices must be developed. Good review of all published articles as of January 2012