An Ounce of Prevention
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.
Thea Blystone, PharmD, is a clinical pharmacist at Meadville (Pa.) Medical Center, which implemented a remote patient monitoring (RPM) program supported by the Prevounce platform. Dr. Blystone was one of the leaders of this project. She spoke with Prevounce about a range of topics, including why she's such a strong proponent of RPM, results of the program, why RPM is a perfect fit for rural organizations, and the evolving role of pharmacists in rural hospitals. Note: Responses have been edited slightly for clarity.
We have learned a lot about how healthcare works — or sometimes doesn't work — over the course of the COVID-19 pandemic. As providers struggled to respond effectively to the fast-spreading virus it became very apparent that we have some outdated and broken components of our healthcare system. COVID stretched our tired healthcare infrastructure to its limits, forcing us to become creative in providing care while accepting and adapting to modern technologies once thought to be prohibitively expensive or else categorized as passing novelties.
Taking the time to prepare your Medicare patients for their annual wellness visit (AWV) can improve the overall experience. For patients, preparation helps to ensure the AWV meets their expectations, as well as feels less stressful and more productive. For you and your practice, prepared patients can expedite completion of the AWV in a manner that still meets patient needs and requirements.
Comprehensive care management — also known as "virtual care management" — combines aspects of chronic care management (CCM), remote patient monitoring (RPM), and other billable preventive services to allow providers to take a whole patient approach to managing the medical, functional, and psychological needs for medium- and high-risk patients. For clinicians, comprehensive care management provides patients with the wraparound care they need, not only promoting wellness but also treating and helping prevent acute exacerbations of chronic health conditions. To be successful, it is important that any care management approach be a team effort, eliciting buy-in from the patient's entire healthcare team as well as the patient themselves.
Lately, some areas of healthcare seem to be evolving at lightning speed, with the COVID-19 pandemic accelerating progress with relative ease. Adopted just a few years prior to the pandemic's onset, chronic care management (CCM) has now been solidified as a service and emerging care model — one that is bridging distance gaps and helping chronic disease patients reach and sustain better health for longer.
"It's usually covered by your health insurance, it doesn't take much time, and it's a great way to learn about your present and future health." So begins a Harvard Men's Health Watch article on why men need an annual wellness visit (AWV), but the sentiment expressed in the article applies to any Medicare beneficiary. The Medicare AWV is a valuable service for practices to offer their patients. It's valuable from a health and wellness perspective as the AWV can help physicians prevent disease and detect health issues faster. It's also valuable from a financial perspective as the AWV is reimbursed well, with practices receiving around $150 in average reimbursement per patient. This can be increased by performing, when appropriate, the many preventive services that can accompany an AWV. If you want to capture that revenue, you will need to know and understand the billing codes for the Medicare annual wellness visit.
Research supports that educational brochures placed and targeted at the right audience can provide great benefits. Since printed brochures are often available at in-person visits, they can facilitate patient interest, generate helpful questions, and encourage patients to initiate important conversations with their healthcare providers about treatments or services, such as chronic care management (CCM), that they otherwise may not have known about.
In a recent blog, we described preventive services as "The Missing Link to Wellness." Research backs this claim up, showing that preventive services have the potential to dramatically reduce healthcare spending, improve economic output by billions of dollars, and save tens of thousands of lives. To help you better appreciate why preventive services should be offered by your practice and what to know before proceeding with adding such an offering, here is some of the essential information to understand about the preventive services Medicare covers.