Accountable care organizations and value-based programs are constantly seeking cost-effective ways to manage chronically ill patients. Each year, more than 1.7 million people lose their lives to complications from chronic diseases such as diabetes, atrial fibrillation, cardiovascular disease, and cancer, among others. On top of everything, chronic diseases contribute to almost 90 percent of US healthcare costs, according to CMS expenditures. These costs equate to $285 billion in annual spending.

There is no question that chronic care management (CCM) is a necessary part of physician care. Since the launch of Medicare reimbursements for CCM services in 2015, physicians have been working towards complete coordination of this revenue opportunity while improving patient care. Elements of CCM services include 24/7 patient access to care, medication management, and patient data recording with the use of efficient EHR technology.

CCM services also became one of the first opportunities for physicians to be reimbursed for care through non-face-to-face means. In other words, consultations over the phone or through other electronic means have become an integral part of healthcare management for chronically ill patients.

While surveys show that an increasing number of physicians wish to carry out CCM services for their own Medicare patients, a multiplicity of different obstacles and compliance measures prove to be a problem. In addition to providing care, physicians must be familiar with reimbursement and coding practices in order to run a CCM program that is both cost effective and beneficial for patient care.

Up until a few years ago, while physician groups reflected interest in chronic care management, many were prudent in adopting full-fledged CCM service programs.

CMS has since launched annual updates in billing codes, payment rates, and quality provisions of services to simplify and abbreviate qualifications for reimbursement. In an effort to incentivize further participation in CCM services, developments have been made concerning:

• Reduction in reporting requirements to alleviate the administrative burden
• Payment for comprehensive care plan advancements
• Specified billing codes for complex vs non-complex CCM services
• Reimbursement for long-term evaluation and management services via non-face-to-face methods

Organizations who are considering the establishment or improvement of their own CCM services may find lower barriers of entry and planning with these updates. In order to mitigate further barriers in CCM initiation, compliance leaders can utilize additional strategies to facilitate the process.

One method to adopt CCM services can include providing remote CPT code tracking by electronic means on a unified platform. The innovation of robust e-health technology has allowed for the opportunity to simplify CCM operations while furnishing a single point of care for physicians and their patients to review labs, schedule appointments, and review care plans. Platforms such as HealthKOS are appropriate for CCM systems to track requirements and quality measures while enhancing communication between healthcare teams.

Nonetheless, it is important to consider all aspects of implementing CCM programs. Staying up to date with regulatory changes and integrating cost-effective strategies into compliance plans is a surefire way to generate the most value from CCM services. Provider, patient, and service qualifications; coherent policies and procedures; and effective development systems for training eligible teams must be established in order to build a foundation for success and implementation into value-based goals of care and greater healthcare initiatives.

The post Solutions to Chronic Care Management appeared first on HealthKOS.

As hospitals are continually being penalized for excessive 30-day readmissions, chronic care management (CCM) has become a rising area of healthcare. Chronic care management in the form of transitions of care (TOC) programs are effective, but still not enough to hinder disease progression. In relatively recent years, CCM methods have started to integrate remote patient monitoring (RPM) systems for further assessment of care.

Chronic Disease Progression, Still A Growing Problem

Hospital readmissions from chronic conditions are costing upwards of half of billion dollars or more, annually. These chronic care conditions are proving to be key sources of rising costs as well as lower quality of care. This could be due to several factors such as non-adherence, low health literacy, or use of several medications from different healthcare providers.

The most prevalent chronic conditions include:

• Heart Disease
• Hypertension
• Chronic Obstructive Pulmonary Disease (COPD)
• Diabetes

These chronic conditions can be assessed according to certain health metrics. Qualitative metrics include diet, lifestyle, and family history. Other quantitative metrics as shown in the table below can also provide more direct monitoring opportunities. These metrics can be compared based on the chronic condition although many patients suffer from more than one chronic condition at a time.

Timely Interventions Are Crucial For CCM

The benefits of CCM extend towards decreasing emergency room visits, hospitalizations, and long-term care admissions. This is due to consistent opportunities to follow up on patient health metrics and overall condition. If abnormalities in vital signs and symptoms are overlooked, the patient is at risk of worsening disease states and eventual hospitalizations.

Therefore, it is not only important to assess chronic conditions with every follow-up, but also provide education and intervention as necessary. Moderate ticks in blood pressure levels, heart rates, and breathing patterns can make all the difference in ensuring optimal patient care. Otherwise, events like exacerbations from asthma or heart failure could send a patient straight to the hospital.

Studies show that health data transmitted by patients remotely can increase the likelihood of  positive patient outcomes. Patients with diabetes, who are receiving consistent chronic care management, have received timely interventions comparable to those after a regular clinic visit.¹ Chronic care management can be boosted to an even higher level with the use of remote patient monitoring.

Remote Patient Monitoring as a Supplemental Solution

Continual advancements in technology have allowed the use of remote patient monitoring systems to improve the quality of care. Clinicians now have the ability to assess patient’s functional, medical, and psychosocial needs via remote platform systems. With easy access and oversight, remote monitoring programs can provide the necessary tools to enhance the management of chronic conditions. 

Patients have the opportunity to keep track of their condition(s) by uploading vitals and health metrics to a secure platform. Clinicians and healthcare providers are then able to analyze patient conditions and provide the necessary feedback to slow disease progression. For instance, a hypertensive patient who is not taking their medications can easily be counseled after noticing a decline in blood pressure values.

Remote patient monitoring can further provide an effortless, low cost way to provide patient education and address adherence concerns. Patient health metrics can be closely tracked and attended to with a comprehensive care plan. This plan can consist of expected outcomes and prognosis, measurable treatment goals, and scheduled medication management visits. By immediately attending to these patient care elements, chronic disease progression can be slowed. Therefore, chronic care management (CCM) plus remote patient monitoring can be an optimal combination for better patient care.

Footnote: 1. Chase, H.P.; Pearson, J.A.; Wightman, C.; Roberts, M.D.; Oderberg, A.D.; Garg, S.K. “Modem transmission of glucose values reduces the costs and need for clinic visits”. Diabetes Care. 26 (5): 1475–1479. doi:10.2337/diacare.26.5.1475.

The post Chronic Care Management Made More Effective With Remote Patient Monitoring appeared first on HealthKOS.

For older patients with chronic conditions, providing dignity of care is an important aspect of improving overall quality of care. Dignity can be appropriately defined as one’s sense of self worth. In healthcare, however, respecting dignity more so encompasses other values such as patient privacy and autonomy. By reminding ourselves of the value in patient dignity, we can identify specific aspects of care to effectively improve patient outcomes.

According to an NHS survey, patients associated dignified care with individual respect and treatment alongside shared decision making and privacy. Performing medical tasks, such as examinations and lab testing, weighed less in terms of importance when evaluating dignified care. Therefore, it is important to build personalized relationships with patients to cultivate treatment plans with dignity in mind.

Patients are facing many vulnerabilities when receiving care for their chronic diseases. They may become confounded with important medical checkups and examinations from multiple teams of physicians and other healthcare providers. Older patient populations have reported personal interactions within the healthcare system which have led to a loss of respectful communication and unfavorable assumptions. These actions can cause barriers where a patient may be reluctant to follow treatment plans. It is our role as providers to protect patient dignity through all means possible.

Communication

Protecting patient dignity can be done through improvements in physician-patient communication. For example, expressing statements of empathy and engaging in active listening are valid ways to support patient dignity. Chronically ill patients may be going through additional stress from high treatment costs. They may also feel a sense of uncertainty on whether their chronic conditions will ever improve. Working with a collaborative mindset with the patient can help gain patient trust and improve patient engagement.

Privacy

With the increased implementation of e-health solutions, patient privacy and data security have become important elements of healthcare processes. Physicians now have an added ethical responsibility to maintain patient-centered care without compromising patient health information. When patients seek medical care, they are essentially forced into putting their trust into a healthcare system that they hope is secure. Online provider platforms must be protected and held liable for patient health information transmitted either remotely or within a health facility.

Data Security

Health consumers, an Experian study reported, may be wary of adopting online platforms to communicate with their physician. 58 percent expressed that privacy and anonymity is essential or very important. Almost 70 percent further indicated the importance of functional security safeguards when using online health platforms. Fortunately, the majority of medical web applications are utilizing secure API, sensitive data encryption, and increased restrictive access to patient health information.

By proactively ensuring these patient values, dignity and quality of care can be markedly improved, especially in older, chronic care populations. Healthcare management should be focused on improving patient outcomes through communication that is both private and secure. Physician organizations can make a meaningful impact on patient care if they coordinate systems that are both pragmatic and capable of protecting patient dignity.

The post Patient Dignity in Chronic Care Management appeared first on HealthKOS.