The new rule brings big changes and huge opportunities for FQHCs. Change is inevitable, but savvy execs see the potential.
[/vc_column_text][vc_column_text]Schedule a complimentary strategy session to learn how these updates can improve outcomes and increase revenue at your health center.- Understand 2024 Rule implications & opportunities.
- Review new remote care management services.
- Capitalize on multiple service lines in the same month.
Embracing Medicare: Transforming Care for Aging Populations
Last week at the CPCA Quality and Technology Conference in Long Beach, CA, a groundbreaking collaboration between Vigilance Health and Bay Area Community Health (BACH) unveiled innovative strategies to enhance care for the aging population under Medicare. Our Executive Director, James Coburn, alongside Dr. Harsha Ramchandani, CMO of Bay Area Community Health, led an enlightening presentation on "Embracing Medicare: Quality Care Strategies for Aging Populations."A United Front in Healthcare Innovation
This collaboration underscores our commitment to pioneering healthcare solutions that not only address the current needs but also anticipate the future of health care populations. With a focus on chronic care management, remote patient monitoring, and integrating comprehensive patient-centered care management, our strategies are designed to propel healthcare forward, ensuring that quality care is accessible and effective for all, especially our aging communities.The Power of Partnership
James Coburn, with his extensive background in healthcare IT and population health management, alongside Dr. Ramchandani, a seasoned healthcare professional dedicated to improving lives, shared their combined expertise. Together, they illuminated the path forward in managing the health needs of the rapidly growing Medicare demographic, emphasizing innovation, partnership, and a deep commitment to patient care.Our Conference Experience: A Hub of Collaboration
Apart from the presentation, the conference was a vibrant hub for exchanging ideas, rekindling old connections, and forging new ones. Our team had the opportunity to exhibit, sharing insights and learning from other healthcare professionals, which only deepened our resolve to drive meaningful change in the healthcare industry.Join Us on This Journey
We believe that our experiences and partnerships position us uniquely to support health centers in enhancing patient outcomes through tailored population health strategies. If your health center is looking to innovate and improve care for aging populations, we invite you to book a 30 minute meeting with us so that we can collaborate on solutions tailored to your health center's unique needs. [ut_button color="blue" target="_self" link="https://calendly.com/mdavis_vigilance/30min" size="small" ]Schedule a Meeting[/ut_button] Don't miss out on the opportunity to elevate your health center's services with our expertise and partnerships. Plus, at every conference, we offer a custom population health strategy report for your health center to help you visualize the impact of a robust population health strategy. Looking forward to meeting more amazing members of our community at the next conference. Together, let's redefine healthcare for our aging populations. Images courtesy of Vigilance Health and California Primary Care Association on LinkedinRequest a Population Health Strategy Report
[/vc_column_text][vc_column_text css=".vc_custom_1709584948509{padding-top: -30px !important;}"]Get a complimentary population health strategy report based on your organization's HRSA/UDS data. Uses your center's clinical outcome data to calculate the potential financial impact of a strong population health strategy. Once you submit your request, our team will prepare your customized report. We'll email you when it's ready for review.[/vc_column_text][vc_column_text css=".vc_custom_1709585205165{padding-top: -40px !important;}"]Population health or care management questions? Email us or call 805.823.0981. [/vc_column_text][ut_fancy_image image="3343"][/ut_fancy_image][/vc_column][vc_column width="1/2"][wpforms id="3881" title="false" description="false"][/vc_column][/vc_row]FQHC Guide Closing Gaps in Care
[/vc_column_text][vc_column_text css=".vc_custom_1709574937154{padding-top: -30px !important;}"]Download the guide for proven methods focusing on consistent patient outreach, education, and appointment scheduling. Goal setting, staff training tips, and action items. Transform patient health outcomes, improve quality scores, and increase reimbursements for value-based care and quality improvement programs.[/vc_column_text][vc_column_text css=".vc_custom_1707346258816{padding-top: -40px !important;}"]If your center is struggling to close gaps in care, Vigilance can help. Email us or call 805.823.0981 to get started.[/vc_column_text][ut_fancy_image image="3776"][/ut_fancy_image][/vc_column][vc_column width="1/2"][wpforms id="3897" title="true" description="false"][/vc_column][/vc_row]Hi, Marc! So nice to have you. Let’s start with a little background on Jane Pauley Community Health Center, that’s a pretty famous name.
Jane Pauley, or JP, as we call it, is central Indiana’s trusted nonprofit provider of affordable primary, behavioral, and dental health services. We’re an FQHC with 10 locations and over 250 staff, providing high-quality care regardless of coverage or ability to pay. Our patient population is about 65 percent Medicaid, 5 percent Medicare, 10 percent uninsured, and 20 percent privately insured. Our name, of course, comes from Emmy-winning TV news personality Jane Pauley. She’s done so many things: The Today Show, Dateline, and now she hosts CBS Sunday Morning. She was born in Indianapolis, Indiana, a fifth-generation Hoosier, and graduated from Indiana University. She also went to Warren Central High School, just a short walk from our offices. Jane Pauley lends us her name to care for her hometown. As a longtime children’s and mental health spokesperson, she’s been vocal in sharing her journey with late-diagnosed bipolar. She’s done a lot to remove stigmas around mental health, taking medications, and getting the care you need. She’s an exceptional person in our state and for our center.There’s been some pretty impressive growth at Jane Pauley. How do you manage that while keeping an eye on quality?
Patient experience and quality of care are part of everything we do. We are always looking for ways to close Gaps in Care (GIC) to improve our care management programs and, ultimately, our quality outcomes. Whether on a staff level or a new technology for EHRs, we want to constantly beef up our internal quality measures. One resource that we could not do without is our amazing Community Resource Navigators (CRNs). Huge shout out to our team!! They are the direct ties to our community and make a huge difference every day. Anyone can make an appointment with a CRN at our center, whether they are patients or not. The HCN helps with access to coverage, care, and other resources. They help sign people up for Medicaid on the spot and help them set up payment plans or apply the sliding fee scale. We’re fortunate to have certified State Health Insurance Assistance Program (SHIP) navigators on our team. They are versed in Medicare and can help with access to state coverage or even dual eligibility.What’s a unique way you’re working to improve outcomes?
Well, here in Indiana, we have an abundance of county fairs. I love a good fair, and being at the booth is always a great time. Fair food is fun, but this is a great chance to educate the community about nutrition or other health resources. However, our primary goal is to get people to schedule an HCN appointment. Let them know we are here, care is available, and we can help them with that process at no cost. When I’m at one of these community outreach events, I always make it a point to speak with any of our patients. I want to know about their experiences with us, both positive and negative. It’s a great way to get to the heart of the issue and see what needs to be fixed. As we know from our board of directors, community members, especially patients, offer the most significant insights.We love to share FQHC wins. Tell us about a care management achievement you are proud of.
While not specific to Indiana, we do struggle with tobacco use, consistently ranking in the country’s top 10. It’s a top priority and a big thorn in the side of every healthcare executive in the state. I’m specifically proud of a hypertension grant that Jane Pauley received. We worked to enroll over 1,100 patients in a hypertension/ high blood pressure improvement program, including free self-monitoring kits. The data collected flowed directly into our Epic EHR system. The program was very successful, with participants showing improved numbers and better overall control of their conditions.Talk to us about adding Chronic Care Management to your strategy.
Like many community health centers, JPHC is navigating our way through Chronic Care Management (CCM): non-face-to-face care coordination services for Medicare’s sickest beneficiaries—those with two or more chronic conditions. It’s a small percentage of our population, maybe 5%, so it can sometimes, I admit, fall to the side. Most health centers are structured that way. I’m honestly not sure why, and with the massive baby boomer generation growing older, we knew we needed to change that. Two things brought CCM to the forefront for me. The first was hearing a 65+ Medicare patient with multiple chronic conditions say, “You are the best-kept secret in town.” While it was a great compliment, we don’t want to be a secret. We want to be a resource and point of access for everyone in our community regardless of their coverage, Medicare, Medicaid, no coverage, private insurers. Especially with the exploding numbers of the 65+ population and their often more complex needs, we want people to know we are here and ready to serve them. The second thing was meeting up with Vigilance at the NACHC CHI Conference in Orlando. They had prepared a Population Health Strategy Report for us, showing how they could help us with that 65+ population. It really enticed me because what they’re offering is something we’d like to do ourselves, but we don’t have the staff, time, or resources to do population health for that Medicare population. Vigilance takes that extra step for us, conversing with patients and saying, " Hey, I noticed you didn’t get your flu shot; why not? Can I schedule your appointment for that? Or I see you were in the office last week, and the provider gave you instructions. Are you following them? If not, let's discuss why you’re not and see if we can rectify that. The model intrigued me, and when I brought this proposal back to our team, the leadership all agreed it was a worthwhile endeavor.Why are Chronic Care Management and similar programs becoming so important?
The 65+ age group is growing, that’s first and foremost. It just makes good sense to be prepared for demographic changes in your community. As people age, they may use the health system more, or maybe they should be but aren’t. They may require a bit more time with an advocate or help navigating complex care directives. We want people to know they can bring in all that overwhelming Medicare paperwork. Just gather it all up, stuff it in a bag, and bring it in. Our team will help you navigate the process and understand your choices for free, whether you are a patient or not. It’s a valuable resource, and we want people to know we're here. Many people also don’t realize that Medicare waives the $200 deductible for patients who go to FQHCs. Eliminating that fee removes one more obstacle to care. When Vigilance helps patients with this type of education, that helps us improve adherence and, ultimately, quality of care.What is the biggest hurdle for an FQHC looking to implement a Chronic Care Management program?
The only thing holding you back is you! The good news is there aren’t many upfront costs involved; eventually, you can bill for these services, creating downstream revenue. Again, this is what caught my eye with Vigilance. It’s kind of like “found revenue” that you didn’t have before.OK, that sounds very appealing. So what will you do with all this ‘Found Revenue’?
We’re big into education. We partner with a large family practice residency program through the Community Health Network. They have 30 residents. It’s a 10/10/10 model, so they graduate ten each year and bring in ten new each year. The residents rotate through one of our sites for their pediatric and OBGYN experience. FQHCs serve the neediest of the needy, and it’s an essential training experience for these providers. We hope to partner with them even more as we continue to grow. Another goal is to start a family nurse practitioner program. I think these programs would benefit any community health center. There’s a provider shortage, and we must consider new ways to handle the unique, growing, and complex needs of FQHC patients and other vulnerable populations. The provider shortage is especially prevalent in behavioral health, one of our fastest-growing service lines, and near and dear to the Jane Pauley mission. Coming out of COVID, we find that 70% of patients who come in for a primary care visit also deal with at least one behavioral health issue. There’s such a need for that type of care. We’ve hired over 40 behavioral health clinicians and could use 40 more. That’s another critical model we’re focusing on.Do you have any community events scheduled for the New Year? We’d love to share!
We’ll be back on the County Fair circuit for sure. But over the winter months, we'll definitely increase our community outreach around flu and other vaccinations. We can also help connect people to important resources like shelters and heating assistance.Marc, it’s been a pleasure speaking with you. Thank you for sharing your experiences. There are so many valuable takeaways for other FQHC leaders considering care management strategies. Again, it's hard to believe it was your first interview; you did an excellent job. Do you have any last thoughts you’d like to offer?
Providing the best possible care is the core of the FQHC mission. Everything we do should orbit around that goal. It’s never easy, and it’s ok to consider outside help. Do whatever it takes to make it happen. As we like to say at Jane Pauley, “If we see 400 patients today, that’s 400 chances to change somebody’s life. Let’s make sure it’s in a positive way.”[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text css_animation="none"][/vc_column_text][vc_column_text]Interested in Chronic Care Management for your FQHC?
Request a complimentary Population Health Strategy Report.
[ut_button color="mid-blue" target="_self" link="https://survey.zohopublic.com/zs/noBTwz" size="large" ]Get Your Custom Report [/ut_button] [/vc_column_text][/vc_column][/vc_row]
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- Improves Patient Outcomes by monitoring patients progress outside of the doctors office
- Gets Patients more involved in there own care, by setting goals and keeping treatment plans relevant
- Allows doctors to more accurately coordinate treatment using months of additional data collected through Remote Patient Monitoring
Request a Population Health Strategy Report
Get a complimentary population health strategy report based on your organization's HRSA/UDS data. The report uses your center's clinical outcome data to calculate the potential financial impact of a strong population health strategy. Once you submit your request, our team will prepare your customized report. We'll email you when it's ready for review. Request a Population Health Strategy Report [/vc_column_text][vc_column_text css=".vc_custom_1710350569654{margin-top: -20px !important;}"]Closing Gaps in Care Infographic
Health centers across the nation are struggling to close gaps in care. At Vigilance, we've been at the forefront of aiding community health centers like yours in overcoming these challenges. Download the Gaps in Care infographic to see the impact of strategic partnerships in achieving clinical goals. Download here...[/vc_column_text][vc_column_text css=".vc_custom_1707325938389{margin-top: -20px !important;padding-top: 120px !important;}"]Qualifying Chronic Conditions:
Patients who are looking to enroll in the Chronic Care Management Program offered by Medicaid must have a minimum of two different chronic conditions to qualify. Below is a list of some of the major qualifying chronic conditions, though there are more conditions that are not listed below. Continue Reading...[/vc_column_text][/vc_column][/vc_row][vc_row full_width="" css=".vc_custom_1595889702837{border-radius: 3px !important;}"][vc_column width="1/2"][ut_fancy_image image="3783" border="#000000"][/ut_fancy_image][/vc_column][vc_column width="1/2" css=".vc_custom_1595890219846{margin-top: -20px !important;border-radius: 5px !important;}"][vc_column_text]G0506 CPT - CCM Program Initiative
Since the beginning of 2017, and continuing into 2020, the G0506 CPT code introduces new policies into CCM program is now compensating providers for the amount of time spent during patient intake. Continue Reading...[/vc_column_text][/vc_column][/vc_row][vc_row full_width="" css=".vc_custom_1595889702837{border-radius: 3px !important;}"][vc_column width="1/2"][ut_fancy_image image="3821" border="#000000"][/ut_fancy_image][/vc_column][vc_column width="1/2" css=".vc_custom_1595890228720{margin-top: -20px !important;border-radius: 5px !important;}"][vc_column_text]Chronic Care Staffing
At Vigilance Health, we understand how daunting CCM, and meeting Medicaids requirements for reimbursement can be. Not only is it daunting to meet the minimum required patient to care manager benchmarks, but also to meet the chronic care staffing necessary to treat each patient. Continue Reading...[/vc_column_text][/vc_column][/vc_row]- Be a condition that is expected to last at least 12 months, or until the death of the patient
- Be a condition that puts the patient at a significant risk of death, functional decline, or exacerbation/decompensation