An Ounce of Prevention
Chronic care management (CCM) is a valuable service to provide to patients that generates strong revenue for practices, and, as we recently discussed, is an "integral component" of the Centers for Medicare & Medicaid Services' (CMS) long-term patient care and coverage strategy. There may be no better time to add or grow a chronic care management program, especially with a reimbursement increase likely on the horizon.
One of the biggest care management challenges faced by modern daypractitioners is keeping patients focused on the immediate problem or reason for a visit. It's often easy to default into personal conversations with the patient as you connect as humans, but aimless conversations and off-topic detours can prove lethal to the typical practice schedule and mean certain essential aspects of the visit are overlooked or missed altogether, thus creating potential issues with reimbursement.
Remote patient monitoring (RPM) is gaining ground and securing its permanency within our evolving healthcare system. Ideal for patients who need close monitoring of their ongoing health concerns, RPM can play an essential role in keeping patients healthier for longer and avoiding the acute exacerbations that can land them in the emergency room or hospital.
The Office of Inspector General (OIG) recently announced it had completed an audit of payments for chronic care management (CCM) services. The results of this audit have short- and long-term implications for providers of CCM services and for the vendors of CCM software that support those providers.
It's been about a month since the Centers for Medicare & Medicaid Services (CMS) published its 2022 Medicare Physician Fee Schedule proposed payment rule. Now that we've had some time to digest the document, we wanted to share thoughts on what we feel are some of the most significant proposed changes concerning telehealth and preventive services (e.g., remote patient monitoring, chronic care management). When the final rule is published, we'll be taking a deeper dive into the approved changes for 2022, including hosting a webinar on the topic. Make sure you join our telehealth regulatory update email list so you don't miss when registration for this program opens.
Update: The 2022 Physician Fee Schedule final rule has delivered a significant increase in reimbursement for some chronic care management services and finalized the addition of new CCM CPT codes. To learn more about the substantial changes to CCM, watch our webinar covering some of the final rule's most significant telehealth and care management developments. Tucked deep within the 2022 Medicare Physician Fee Schedule proposed rule, presumably where it would be easy to miss, the Centers for Medicare & Medicaid Services (CMS) has penned a love letter to chronic care management.
Telehealth has emerged as a viable and valuable delivery care model, with remote patient monitoring (RPM) as one of the most effective forms of virtual care. While not technically a new concept, RPM has been around since the late 1960s. Since then, it has expanded and morphed into the useful solution and service it is today while gaining acceptance from practitioners, patients, payers, and the federal government.
More than 6 million adults in the United States have congestive heart failure (CHF), according to the most recent data from the Centers for Disease Control and Prevention, with heart failure costing the nation more than $30 billion annually. Both figures are expected to rise in the coming years, fueled by the “silver tsunami” of aging baby boomers, unhealthy lifestyles taking their toll, and chronic medical conditions like obesity, high blood pressure, and diabetes raising the risk of developing CHF. Since CHF is so prevalent, it's more important than ever to find effective treatment solutions that won't break the bank for patients and that help provide better control over our national healthcare spending. Enter remote patient monitoring for congestive heart failure.
There are currently dozens of telehealth bills in Congress. As is the case with most pieces of federal legislation, a majority of these bills will go nowhere. However, some have the potential to become law and significantly reshape or at least affect the rules concerning the delivery and coverage of telehealth services.
Update: The 2022 Medicare Physician Fee Schedule (PFS) final rule further defined remote therapeutic monitoring (RTM), including finalizing five RTM CPT general medicine codes, but left many questions unanswered while also limiting coverage for these codes. You can learn more about the current state of RTM in this Physicians Practice column discussing the 2022 final rule written by Prevounce Co-Founder Daniel Tashnek.We anticipate receiving more information and clarification concerning RTM in the 2023 PFS proposed and final rules. * * * The Centers for Medicare & Medicaid Services (CMS) has issued its 2022 Medicare Physician Fee Schedule proposed rule. Within it are some potentially significant developments concerning remote therapeutic monitoring, which we will discuss below.