MORE CRITICAL THAN EVER BEFORE

CARE MANAGEMENT

A strategic step toward improving outcomes in a value-based reimbursement era.
HIGH QUALITY - LOW COST OUTCOMES

CARE COORDINATION IS A KEY FEATURE
OF EVOLVING CARE MODELS

As the shift to value-based reimbursement requires healthcare providers assume greater responsibility for care outcomes, you must find new ways to engage and partner with your patients. Vigilance Health solves this problem with a comprehensive, patient-centered care management platform and care management team.

HIGH QUALITY - LOW COST OUTCOMES

CARE COORDINATION IS A KEY FEATURE
OF EVOLVING CARE MODELS

As the shift to value-based reimbursement requires healthcare providers assume greater responsibility for care outcomes, you must find new ways to engage and partner with your patients. Vigilance Health solves this problem with a comprehensive, patient-centered care management platform and care management team.

CARE MANAGEMENT PLATFORM

The platform utilizes predictive modeling algorithms to identify risk profiles for program participants, creates unified, evidence-based care plans, manages interventions and barriers to care, such as basic living, transportation, economic and education needs – all of which can prevent patients from realizing optimal outcomes.

VIGILANCE HEALTH CARE TEAM

Our experienced Care Coordinators manage and gauge a member’s knowledge of his or her condition, adherence to the physician’s treatment plan, support systems, self-management, medical history, labs and medications. We also help the patient develop a plan and set goals, and overcome the barriers to managing their condition.

NEW REVENUE STREAMS

GET PAID NOW AND PREPARE
FOR THE FUTURE

To succeed under alternative payment models, healthcare providers need to develop population health management (PHM) skills and infrastructure. But with fee-for-service (FFS) reimbursement still dominating most markets, many providers are hesitant to make necessary investments.

However, we help Providers realize a substantial short-term return on these investments through FFS payments for PHM services. Specifically, the Medicare Physician Fee Schedule now includes payment for the following six PHM services, and provides a clear path to new revenue.

MEDICARE'S CCM & COMPLEX CCM

Increase practice revenue by billing CPT codes 99490, 99487, 99489.

TRANSITIONAL CARE MANAGEMENT

Increase practice revenue by billing CPT codes 99495 and 99496.

ADVANCED CARE PLANNING

Increase practice revenue by billing CPT codeS 99497, 99498.

MIPS PERFORMANCE INCENTIVES

Increase practice revenue through the Quality Payment Program performance measures.

CARE PLAN DEVELOPMENT

Increase practice revenue by billing CPT code G0506.

ANNUAL WELLNESS VISITS

Increase practice revenue by billing CPT codes G0438, G0439.

NEW REVENUE STREAMS

GET PAID NOW AND PREPARE
FOR THE FUTURE

To succeed under alternative payment models, healthcare providers need to develop population health management (PHM) skills and infrastructure. But with fee-for-service (FFS) reimbursement still dominating most markets, many providers are hesitant to make necessary investments.

However, we help Providers realize a substantial short-term return on these investments through FFS payments for PHM services. Specifically, the Medicare Physician Fee Schedule now includes payment for the following six PHM services, and provides a clear path to new revenue.

MEDICARE'S CCM & COMPLEX CCM

Increase practice revenue by billing CPT codes 99490, 99487, 99489.

TRANSITIONAL CARE MANAGEMENT

Increase practice revenue by billing CPT codes 99495 and 99496.

ADVANCED CARE PLANNING

Increase practice revenue by billing CPT codeS 99497, 99498.

MIPS PERFORMANCE INCENTIVES

Increase practice revenue through the Quality Payment Program performance measures.

CARE PLAN DEVELOPMENT

Increase practice revenue by billing CPT code G0506.

ANNUAL WELLNESS VISITS

Increase practice revenue by billing CPT codes G0438, G0439.

With the growth of value-based incentives and risk-based contracting, provider organizations have
started to think of care management as an integral part of their population health strategies.
VIGILANCE HEALTH
NEW OPPORTUNITY

BEHAVIORAL HEALTH
INTEGRATION SERVICES

Effective January 1, 2017, CMS now reimburses practitioners for integrating behavioral health services into their primary care practices. Like CCM and TCM, Medicare will make monthly payments for Behavioral Health Integration (BHI) services.

There are two categories of BHI services: Psychiatric Collaborative Care Services (CoCM) and General BHI.

COCM: which is more resource intensive, takes “typical” primary care services and incorporates care management and regular psychiatric support.

GENERAL BHI: can be billed for core behavioral health services, including systematic assessment and monitoring, care plan revision, and relationship development with a care team member.

FUTURE OPPORTUNITY

MEDICARE DIABETES
PREVENTION PROGRAM

Beginning January 1, 2018, practitioners enrolled in the Medicare Diabetes Prevention Program (MDPP) will be reimbursed for furnishing specified services for qualifying Medicare beneficiaries.

These services, furnished over a 12 month period, include at least 16 weekly core hour-long sessions, over months 1-6, and at least six monthly core maintenance sessions over months 6-12. Beneficiaries then are eligible for additional services if they achieve and maintain the required minimum weight loss of 5% in the preceding 3 months.

LET'S START A CONVERSATION.

Vigilance Health is ready to lead you into the future of Value-Based Healthcare. We're here to provide you with more information, answer any questions you may have, and create an effective solution for your value-based care delivery and reimbursement needs.

  • (805) 823-0981
  • contact@vigilancehit.com
  • VigilanceHealth.com

 

CONTACT US

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