An Ounce of Prevention
New Medicare Chronic Care Service: Chronic Pain Management (CPM)
Read More →There were a number of significant changes affecting the delivery and billing of remote care management in the 2023 Medicare Physician Fee Schedule (PFS) final rule, as we covered in this webinar. One of them was the Centers for Medicare & Medicaid Services (CMS) finalizing the coverage for chronic pain management and treatment services (CPM) — new services that were introduced in the 2023 Medicare PFS proposed rule.
Medicare's annual wellness visit (AWV) has had a rocky ride since its introduction in 2010 and started in 2011 as part of the Affordable Care Act. As with many big healthcare changes, the new service was met with resistance and steeped in confusion, leading to terribly slow uptake and obstacles that still unjustly plague the service more than a decade later. When Medicare beneficiaries do not receive their AWV, this is not only a disservice to these patients, but practices and the healthcare system as a whole lose out on important and impactful benefits.
As a practitioner, you understand how beneficial a cardiovascular risk assessment is for your patients. While assessing and treating your patient's cardiac risk factors is beneficial, it can eat up one of your most valuable resources: time. Finding time-saving tools that you can trust and rely on forcompliance and accuracy is almost as important as performing the risk assessment itself.
I'm sure we're all aware of the American way of life — the one where many of us actively partake in regular bad habits like smoking, drinking, consuming unhealthy foods, and look past our largely inactive lifestyles where only about 23% of us actually get the recommended 150 minutes of aerobic and muscle-strengthening exercise per week. While the impact of these not-so-great choices may be out of sight and therefore out of mind for younger people, the reality is that the delayed effects are just a ticking time-bomb of chronic disease waiting to happen.
Part two in a two-part series (access part one) Imagine calling your chronic care case management patient for their weekly check-in only to find out that they haven't taken their blood pressure medication in four days. While the direct effect of the missed medication is worrisome, even more concerning might be the reason why the patient is skipping doses in the first place. Within chronic care management programs, it's not uncommon to run into these types of patient problems, and these situations probably arise more often than we like, or we'd like to admit. Often, the cause or a significant contributing factor to patient non-adherence with a chronic care management program is social determinants of health (SDoH).
Part one in a two-part series It's been well-documented that social determinants impact the health and wellness of patients in numerous ways, but how do we more effectively address those issues that impact patients negatively? One path provider organizations are increasingly taking to help them overcome social determinants of health (SDoH) challenges is through the addition of chronic care management solutions.
The results of a survey suggest that upwards of about 85% of Medicare annual wellness visits (AWV) may fail to meet compliance requirements set forth by the Centers for Medicare & Medicaid Services (CMS). The results should motivate providers to verify that the tools they are using during AWVs for Medicare patients effectively prompts them to ensure no required components are missed. If a required element is missed, the AWV can be considered non-compliant by an auditor, potentially leading to clawbacks and other penalties. In egregious and willful cases, a non-compliant practice could even face exclusion from Medicare or criminal liability.
There are numerous benefits of chronic care management (CCM) that help patients, providers, and payers alike. Since chronic disease is a runaway freight train here in the United States the chronic care management model is functioning somewhat as a proverbial emergency break, slowing down the speed in which chronic disease is impacting our economy and our patients' health and longevity.
If you read our previous post about the love affair between chronic care management and Medicare, then you already have a pretty good idea of how invested the Centers for Medicare & Medicaid Services (CMS) is in the provision of chronic care management (CCM) services. But what does this really mean for you and your patients, and why should you leverage this bonded relationship for the benefit of your organization?
Natural disasters are rarely expected but should be planned and practiced for regularly by everyone. In the medical world, being ready for a natural disaster means so much more than maintaining adequate staffing and supplies. It also means being able to connect with patients at a time when they may need you the most.
Prevounce creates wellness that works for everyone, with practice-specific, software-based programs that make preventive care, chronic care management, and remote patient monitoring easier to prep for, perform, document, and bill.
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