An Ounce of Prevention
Diabetes is quickly becoming one of the more prolific chronic diseases in the United States. Statistics from the Centers for Disease Control and Prevention (CDC) indicate that diabetes has climbed up the cause of death rankings in recent years and is now the number seven most common cause of death. Diabetes affects more than 37 million Americans. This translates to about 11% of the U.S. population who need to deal with the health-related fallout of diabetes, costing them both health and life longevity as well as billions of dollars.
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.
CMS recently released its 2023 Medicare physician fee schedule proposed rule. There are some noteworthy, proposed additions and changes that, if approved, would significantly affect the delivery, coding, and billing of preventive services, remote care management — including remote therapeutic monitoring (RTM) — and telehealth.
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.
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.