Kristine Kapusta

- GET TO KNOW - Chronic Care Management Chronic Care Management stands as an outstanding program with substantial incentives for both you and your patients. Proper planning and care coordination services provide the key to CCM success. 99490 99487 99489 G0511 Chronic Care Snapshot 68% 93% 70% OF MEDICARE BENEFICIARIES HAVE 2+ CHRONIC CONDITIONS 1 OF ALL MEDICARE SPENDING IS DUE TO CHRONIC CONDITIONS 2 OF ALL DEATHS ARE THE RESULT OF A CHRONIC ILLNESS 2 CCM supports PATIENTS & PRACTICES CMS’s program works to provide more care and support to your patients resulting in greater compliance and outcome. COMPENSATION for non-face-to-face communication SLOW THE GROWTH of Healthcare Spending SHIFT PRACTICES to Value-Based Care Models REDUCE UNNECESSARY ER & Physician Visits ELIGIBILITY POOL OUT OF 59 MILLION people on Medicare... 40 MILLION 4 1 YET ONLY 100,000 HAVE 2+ CHRONIC CONDITIONS 3 WERE ENROLLED THAT’S 99.7% OF UNTAPPED Only 11% of practices definitively rejected participating. 89% may still be on the fence. REIMBURSEMENT OR OVER 20 BILLION DOLLARS! WHY SLOW ENROLLMENT? Most practices are optimistic about opportunities with CCM but have struggled with implementation. Many of those who have implemented the program have done so at such a low scale, the results are less than optimal. Lack of Education & Awareness Burden of Patient Documentation Fear of Burden on Time & Resources Outsourcing MAY BE THE KEY Fortunately, CCM services can be rendered under General Supervision. To optimize success, many practices choose to work with a care coordinating program to outsource the CCM requirements, making this valuable program within reach. Choosing to outsource to a dedicated Chronic Care team is a smart way to participate in the program without sacrificing your staff or resources. REASONS TO OUTSOURCE Lack of Adequate Technology Most EMR’s lack the required functionality for important modules that allow for proper time tracking, care plan creation, and more. Limited Internal Staffing Resources CCM requires licensed “clinical staff” to complete requirements. The coordinator must be accessible 24/7 to meet the patient’s needs. Mitigate Risk Implementing an “in-house” CCM program would mean hiring new staff, acquiring new technology, and many other investments increasing risk. Support for your BOTTOM LINE Practices can expect to see around $42 per patient per month, but they must fulfill a few requirements to qualify. SCHEDULING Routine & Referral Appointments - $ 42.71 5 average billed per patient per month CARE TRANSITION CARE PLAN Implementation & Maintenance Management $ 512,520 5 Potential Revenue Gained 20 MINUTES Non-Face-to-Face per month 24/7 Access to Chronic Care needs $ 42.71 Billable per Month 42,710 Revenue per month 512,520 Revenue per year x1000 $ ELECTRONIC RECORD Exchange Across Providers $ Enrolled Patients KEY BENEFITS INCREASE QUALITY OF CARE OPTIMIZE NEW REVENUE Strengthen care management to enhance the wellness of your chronically ill patients, resulting in better outcomes and experiences. Experience increased appointment volumes and patient interaction between office visits with no impact on current personnel & work flows. VALUE-BASED HEALTHCARE MANAGE RISKS & TRANSITIONS Be rewarded for helping patients improve their health, reducing the effects and incidence of chronic disease, and live healthier lives in an evidence-based way. Patient Care Management, tracking, and cost-containment of high-risk cases deliver improved medical outcomes and quantifiable savings. At CareHarmony, we are singular in focus—we seek to improve the patient experience and clinical outcomes by providing compassionate, whole-person care coordination services. Our high-tech, high-touch offering includes a turnkey Chronic Care Management solution designed to offer healthcare providers an easy, limited-risk first step into value-based care. SOURCES: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Chronic-Conditions/MCC_Main.html http://mptrms.mckesson.com/rs/766-XNA-725/images/McKesson-Chronic-Care-Management-eGuide-2017.pdf https://www.linkedin.com/pulse/lessons-learned-year-1-chronic-care-management-travis-bond 4 https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Dashboard/Medicare-Enrollment/Enrollment%20Dashboard.html 5 https://www.cms.gov/apps/physician-fee-schedule/license-agreement.aspx 1 2 3