A recent survey indicates healthcare providers are eager to adopt a chronic care management platform that would qualify them for newly available Medicare reimbursements. Part of the platform might include mHealth or telehealth capabilities that would enable the providers to monitor their patients at home.
The survey, by Kryptiq, a Beaverton, Ore.-based developer of population health management solutions, found that 76 percent of respondents "would organize and structure to meet chronic care management program requirements" within six months, while 92 percent said they'd make that move within the year.
Under new rules that went into effect January 1, the Centers for Medicare & Medicaid Services is reimbursing providers who actively manage Medicare patients diagnosed with two or more chronic conditions. The care delivery program must include a certified EHR, patient consent, the delivery of five core care management services and at least 20 minutes of non-face-time follow-up care outside the office each month.
That non-face-time care requirement could be met by a telehealth or mHealth platform that accommodates home-based monitoring tools, including videoconferencing. CMS, in fact, unveiled new CPT codes late last year that allow Medicare reimbursement for remote patient monitoring of chronic conditions.
“Medicare beneficiaries got an important treat for home care of chronic care management, remote patient monitoring of chronic conditions and other services when provided via telehealth,” Jonathan Linkous, CEO of the American Telemedicine Association – whose organization had been lobbying for reimbursement for the past five years - said in a November 2014 press release. “It has been a long time coming, but this rulemaking signals a clear and bold step in the right direction for Medicare. This allows providers to use telemedicine technology to improve the cost and quality of healthcare delivery.”
The Kryptiq survey highlights providers' willingness to move beyond episodic care and adopt a health management plan for chronic care patients that focuses on value-based care. mHealth advocates have long argued that chronic care management should be continuous, enabling providers to communicate with those patients (and vice versa) at any time and place to ensure that care plans are being followed and health issues are addressed before they become serious.
It also indicates widespread interest in reimbursement strategies.
"The survey results provide additional evidence that the transition from volume to value is underway," Cynthia Burghard, a research director at IDC Health Insights, said in a press release issued by Kryptiq. "For the first time, the Department of Health and Human Services has developed a timetable with specific milestones and thresholds detailing Medicare's shift toward new value-based payment models. The CCM program serves as an extension of health policy and complements ongoing changes to provider reimbursement."
The survey also exposes a hitch in the move toward value-based care. More than a quarter of those surveyed said they're focused on "competing health IT interests," such as an EHR implementation; 46 percent, meanwhile, said they don't have the staff or resources to effectively implement a chronic care program, and 15 percent felt they don't have the right technology.
"It can be tough to hear that your EHR implementation, the result of much organizational blood, sweat and tears, is inadequate for emerging models of value-based care such as chronic care management," Malcolm Costello, Kryptiq's general manager of population health, said in the release. "Fortunately, many providers are already extending their staff into care coordination activities in pursuit of other value-based initiatives such as pay-for-performance or patient-centered medical home."
