Launching a Profitable Care Management Program

Posted by JohnyParker on February 8th, 2021

Ever since CMS updated their fee schedule 3 years ago, care management programs have been exploding in popularity among healthcare providers and health systems across the country. Care management programs offer a variety of benefits including increased patient in treatment, early intervention for improved clinical outcomes, and increased practice revenue.

Nevertheless, efficient care management isn't easy. Organizations need intelligent software capable of delivering population-based insights on the wellbeing of their chronic care patients’.  to help healthcare providers and health systems better manage large populations of high-risk patients. In this article we’ll be discussing the steps for implementing an effective care management program.

Choosing Connected Health Devices

The first step in launching a care management program is determining what types of data you need to collect. For example, cardiologists will want to prompt patients to purchase a Bluetooth connected smartwatch to collect heart rate, and a Bluetooth blood pressure monitor to collect blood pressure readings. Pulmonologists may want to prompt patients to purchase a Bluetooth enabled spirometer. You will need to decide whether you pre-purchase connected health devices which you temporarily rent out to patients, or if you prompt patients to purchase devices on their own accord. Luckily, CMS will reimburse patients for any medical device, and compensate healthcare providers for collecting 16 days worth of data on the device.

Choosing Care Management Software:

When choosing care management or remote patient monitoring software, it’s essential find a multi-specialty platform which is able to collect data on a variety of medical and behavioral health conditions from a wide variety of connected health devices. For example, 90Health’s platform continuously collects data on over 20 different chronic diseases including diabetes, heart disease, cancer, asthma, COPD, obesity, muscle & joint pain, dyslipidemia, addiction, depression, and more. 90Health’s platform is connected to hundreds of Bluetooth connected devices, which collect data on over 20 chronic conditions. Examples, of devices 90Health’s platform is connected to include: Smart scales, smartwatches, blood glucose monitors, inhalers, spirometers, blood pressure monitors, and portable EKG’s. 

Onboarding Patients

Enrolling patients into a chronic care program tends to be quite simple. Typically a nurse will call the patient once they’ve received a connected health device to walk them through the setup process. Setting patients up typically only takes about 5 minutes of time, and CMS reimburses healthcare providers for each interaction.

Data Analytics & Clinical Alerts:

Once patients have been setup on a care management platform and have been instructed on how to properly use the connected health device the next step is all about collecting data. Bluetooth connected health devices are perfect instruments for collecting continuous data on patients medical and behavioral conditions. It’s important to select care management or remote patient monitoring software which uses artificial intelligence to deliver timely actionable insights to your clinical team. 90Health understands sorting through weeks’ worth of patient data is a cumbersome and time-consuming task. 90Health’s intelligent software serves up only the most relevant alerts on escalating patients to your clinical team, enabling early intervention for improved outcomes.

Patient Follow-Up:

At the end of each 30 days, we recommend that a member of your clinical team follows up with the patient to review their progress over the past month. CMS allows either a doctor or a nurse under the doctor’s supervision to follow-up with the patient. Reimbursement for follow-up visits is typically for an initial 20 minutes of reviewing patient data and a face-to-face or telemedicine visit to discuss progress. For an additional 20 minutes of consultation or review of data, code 99458, CMS reimburses an additional . CMS also reimburses for a 99091, or 30 minutes of clinician review of RPM data per month which does not require an interaction or consultation with the patient.

Conclusion

At the core, care management seeks to empower people to manage their health better and to foster healthier lifestyles. At the same time, care management helps healthcare providers boost revenue and improve outcomes. If you are interested in learning more about launching a care management program of your own, reach out to 90health.com today.