Today, nearly half the population has at least one chronic condition. These conditions account for 75 percent of national health care spending. But they are among the most preventative health care problems in the United States. If we could help patients better manage their conditions between office visits, then we could reduce patient provider costs, improve care quality and outcomes, and even save lives. But there is a problem.
Health care organizations are struggling to make an impact.
That’s why the Centers for Medicare and Medicaid Services recently began a new chronic care management program. It reimburses providers for non face to face consultations with Medicare patients who have chronic conditions. By meeting CMBS requirements, you can bill an average of forty three dollars per month per patient. That means if you were to enroll just seventy five of your eligible Medicare patients, you would see an estimated revenue increase of thirty eight thousand seven hundred dollars annually. Problem solved, right?
Not exactly. This GCM program requires a minimum 20 minutes of clinical staff time per month directed by a physician or other qualified health care professional.
If you enroll seventy five patients, that’s 300 hours per year just for the clinical consultations. Plus, there’s the additional time for documentation and billing. Also, since each cars weren’t really designed for CCN and compliance is essential for reimbursement. Many providers may need to invest in technology, staff and training to successfully meet the program requirements on their own.
This can get costly. But what if there’s a way to participate in this CCMA program without the upfront costs?
Here’s where we can help our care coordination team. Nursing and clinical support staff will perform as an extension of your physician’s office, eliminating the need for additional technology and staff. We’ll talk monthly with your Medicare patients about adherence to physician’s directives and medication orders. Developing a care plan and setting goals. And we’ll even coordinate care among physicians, caregivers and support service will maintain the necessary documentation.
Share patient records appropriately and provide invoices. Meeting these E.M.S. billing requirements will create a new revenue stream with no upfront costs or capital investments. And it will go directly to your bottom line. Chronic care management can also be a low risk way to improve population health, increase value based reimbursements and improve your merit based incentive program scores. You already know the financial impacts of these scores can amount to millions of dollars per organization and are set to grow significantly over the next several years.
The Vigilent CCMA Service provides a straightforward approach that will help you control costs, generate new revenue and move your organization one step closer to value based care. This program is not only a good business Medicare, it’s good medicine. As Benjamin Franklin once said, an ounce of prevention is worth a pound of cure. For more information about our care management and other Value-Based services, we encourage you to email or call us today!