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Blog Post

Jan 15

Coordinated Care Management.

Now is the time for effective and coordinated care management. If you have practice has not been taking advantage of the programs covered by Medicare and many other plans, do not delay any longer.

Care management encompasses numerous services, both face-to-face and not.  Think about it, providers and clinical staff perform many tasks outside of E/M visits to help the most seriously ill patients who experience chronic comorbidities all with the goal of keeping them out of the hospital and on the road to better health outcomes.  Outside of care management services there is tremendous amount of effort likely goes uncompensated by the insurance companies.

It is true the care management services we recommend for primary care and internal medicine, and sometimes some specialty offices, sound like a series of government agencies or some type of health care alphabet soup. Services like CCM, RPM, TCM , PCM, and others can have a profoundly positive impact not only on your patients but also your provider quality score and your practice revenue. And getting started can be as easy as 1 – 2 – 3.

If you want more information about care management services that can help your practice and your patients through what might be tough times ahead, register on our site and submit the “Get Help” survey associated with the topic(s) you want to explore.

Although we recommend employing a combination of care management and preventive services that match your patient needs as well as your style of care delivery, every time you incorporate one of these services you will want to do the following:

1.  Identify and enroll.

Apply the criteria defined by Medicare against your current active patient panel try again if I those that may be eligible. Using multiple methods of communication to inform your patients about the program you can find several points of connection through which you can enroll your patients.

Most recurring services require informed consent. Ensure your consent form meets the requirements. Even in instances in which verbal consent is accepted we strongly recommend following up with a written informed consent as soon as possible to complete the file.

2. Collect and report.

Use the available technology and systems to collect the relevant data, patient information, vitals - especially if performing RPM, and capture all clinical staff actions associated, including the provider.

Ensure you record the dates, times, actions, and the individuals involved. This data should be consolidated as part of a support document or chart entry and associated with the billing. Attention to detail is critical to ensure there is no double-counting of time between services. Those details will help you survive any potential audit.

3.  Analyze and engage.

Now that you have the data, make it work for you. Review the information collected in the context of the patient and all chronic comorbidities. In context this will assist the provider in either developing or updating the treatment plan. Likewise, the trends and information gleaned from the data will help the clinical staff better engage the patient and increase the patient’s level of participation in their care.

The 3-step process supports these care management services, as well as preventive services, and links into all care efforts throughout the clinic.  A coordinated care management effort will not only increase patient engagement, but studies also show it can lead to greater participation in preventive care as well.

All this coordinated effort serves to encourage a healthier patient who will enjoy a better quality of life.  Your patients will spend their time enjoying life more fully and they will have you and your clinical staff to thank.

Additionally, these efforts help decrease the total cost of health care. Patients who are more compliant and more engaged tend to have fewer ER visits, hospitalizations, and readmissions. Plus, they tend to be more compliant with their medications and keep their appointments.

There really is no downside to employing an effective coordinated care management program.  If you want to learn more about why we strongly recommend CCM, RPM, etc., schedule a strategy discussion and we can talk.