Physicians' Offices and Remote Care Management

Medical practices are adopting a wide range of value-based care models with private payers, Medicaid, ACOs, and other initiatives. These changes over the past 10 years have generally imposed significant risks to practices, major changes in operations, and are complex and time consuming to administer. The trend, however, is moving forward quickly and practices are increasingly finding opportunities as well as successfully addressing many of the challenges.

But the pace of change may now even accelerate faster----with the adoption of Medicare’s new Remote Care Management program.

Medicare Dives In Big with a
Value-Based Care Program

The biggest change in years is the new Remote Care Management billing codes announced by Medicare in October of 2018. Remote Care management is now an official part of Medicare and all patients 65 and older are eligible.

Medicare’s new program isn’t a value-based care model, inherently, it’s more of an opening of a new set of billing codes extending prior programs thereby limiting the risk to practices while providing a significant upside that many observers expect that physicians, patients, and Medicare may find highly beneficial.

Every physician that serves Medicare patients should seriously evaluate participating in the Remote Care Management program (it covers three different billing codes). Practices familiar with Chronic Care Management will see significant improvements in the program.

Key Take Away

Engaging with a technology partner to make these programs effective for your practice, and to fit into existing workflows

What's Different Now with Remote Care Management

Practices familiar with Chronic Care Management will see significant improvements in the Remote Care program:

  • All patients are eligible (Medicare)
  • There is no termination date for any patient or maximum time on the program
  • The revenue potential is considerably higher, almost 300% higher or over $110 per month (2 separate billing codes) compared to $42 for chronic care management
  • Patients can be eligible for both remote care management and chronic care management yielding over $150 per month in patient revenue but time spent per patient in this version is 40 minutes versus 20 minutes per month if only on one program.
  • Separate co-pays are required for each program enrolled with a patient

It’s quite clear that this is a major policy shift by Medicare to focus on the primary care physicians relationships with patients to improve patient health by incenting on going interaction between patients and physicians.

Benefits For Patients

  • Early detection of health issues proven to improve outcomes and costs
  • Remote care programs provide important feedback increasing adherence
  • Equipment provides direct measurement of health data
  • Day-to-day monitoring offers a more accurate view of patient’s health
  • Better outcomes, easy to do, saves time and money

Financial Benefits

  • Medicare and other payers now adopting programs to incent primary care physicians and other health care organizations to adopt remote care management
  • New Medicare billing codes 99454 and 99457 combined, provides up to $114 in monthly compensation per patient.  No restrictions, everyone 65 and older is eligible. Must have equipment placed in home and directly communicate to physician (no self-reporting of data).  Limited today to physicians
  • Patient co-pay required
  • Healthier patients, higher satisfaction scores
  • Private insurers adopting other programs with similar characteristics
  • 100 patients can generate $100,000 or more in annual income for physicians

Benefits To Staff

  • RCP is a full-service platform that minimizes burdens on staff
  • Ordering portal, delivery of equipment, RCP Hub minimizes work of patient to set up (just plug it in). No need for pairing of Bluetooth devices or access to patient Wi-Fi service or cell phone
  • RCP cloud-based software and apps allow for easy interaction with service and to comply with Medicare and other payer requirements
  • Be up and running in days
  • Use RCP provided marketing materials to assist you with informing patients
  • Detailed logs and summary information
Patient Screen

Medicare Home Health Care Agencies

RCP’s low monthly costs can be an important part of your efforts to manage readmission risk and include detailed patient data in reports to physicians and hospital systems.

Medicare Home Care Agencies are also looking to RCP solutions to modify care plans that leverage internal resources more efficiently. Our first Medicare Home Care Agencies are experimenting with different application models: one key is that RCP provides virtually continuous data. Other agencies are selectively substituting devices and remote management for labor costs.

Private Duty Home Care Agencies

Private Duty Home Care Agencies need to adopt technology to meet the needs of their patients and families. A labor shortage is certainly a driving force, however, the low cost per month of a monitoring solution offers the opportunity to create combined services that better provide for patient care. The easy to deploy solution from RCP combined with automated check in services allow for a variety of service offerings, better matching labor resources and meet the budgetary limitations of many seniors and their families. Talk to RCP today about how its capabilities can be best deployed at your Agency.

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