Category: HCCIntel

Categories
HCCIntel Legislative News

HHS and CMS Announce Brad Smith as CMMI Director, Senior Advisor for Value-Based Transformation

January 6, 2020
Press Release from U.S. Department of Health & Human Services

Today, the Department of Health and Human Services and the Centers for Medicare & Medicaid Services announced that Brad Smith will serve as Director of the Center for Medicare & Medicaid Innovation at CMS and Senior Advisor to Secretary Azar for Value-Based Transformation.

Smith most recently served as the Chief Operating Officer of Anthem’s Diversified Business Group and was previously co-founder and CEO of Aspire Health, a healthcare company focused on providing home-based palliative care services to patients facing serious illnesses.

“Brad will help HHS and CMS continue and accelerate the value-based transformation work that we have begun under President Trump,” said Secretary Azar. “Delivering better value in healthcare is a key piece of how we’re executing on President Trump’s healthcare vision. Paying for outcomes rather than procedures through CMMI models is an important tool for the value-based transformation of healthcare that President Trump has prioritized. Brad has impressive experience with innovative care delivery and paying for value, and he will help expand Administrator Verma’s and CMS’s efforts to ensure Medicare and Medicaid beneficiaries are getting better care, and better health, at a lower cost.”

“Brad’s experience thinking outside-the-box to improve healthcare as a successful entrepreneur, along with his stellar academic and policy background, have prepared him well to lead CMMI and bring innovative solutions to our healthcare system’s most pressing challenges,” said CMS Administrator Seema Verma. “I am excited that we have selected Brad to join the ranks of CMS and help us build on the important work the Trump Administration has undertaken to transform our healthcare system to deliver better value to patients.”

###
Categories
Benefits of HBPC HCCIntel Training Training & Education

HCCI House Call Practicum™ Helps Set Providers up for Success

Providers with patient and caregiver

About this Article:

Learn more about the HCCI House Call Practicum™ from one of its recent participants. The program offers a unique two-day ridealong, an individualized educational experience offering learners the opportunity to shadow both direct clinical care and back-office practice support.

Article:

Home-Based Primary Care (HBPC) describes the field of providing quality medical care in the home to patients who have difficulty obtaining, or are completely unable to access, office-based primary care. This is typically because they are frail, chronically ill, functionally limited and/or homebound. This type of care can provide many benefits, including the reduction of emergency room visits and hospital readmissions, along with improving overall health outcomes and reducing health care costs. One of the main goals of the Home Centered Care Institute (HCCI) is to educate providers and practices in providing HBPC, oftentimes referred to as “house calls.”

The HCCI House Call Practicum™, one of HCCI’s educational offerings, allows participants to acquire new knowledge and skills in house call operations and clinical care for medically complex patients in the home. For those considering adding house call services to their practice, the Practicum illustrates key fundamental processes, systems and approaches. For those already practicing HBPC, the Practicum provides an opportunity to improve upon what they’re currently doing by learning directly from leaders in the field.

Earlier this year, Lynn Simpkins, Nurse Practitioner, Bon Secours Health System, participated in the Practicum with Cleveland Clinic, an HCCI Center of Excellence for Home-Based Primary Care and Practice Excellence Partner™. Simpkins has built her 30+ year career as a family and geriatric nurse practitioner and is currently focusing on home-based care. She recently shared takeaways from her Practicum experience with HCCInsights.

HCCInsights: What are some challenges that you face daily with your HBPC practice?

Simpkins: Like most providers, we have the challenge of a sick patient population but with the added complexity of providing those patients with care in a home setting. Social, financial and unique medical challenges all play into what we need to address.

HCCInsights: Why did you decide to participate in the HCCI House Call Practicum™?

Simpkins: In addition to the challenges I mentioned, during my work with our HBPC program, our practice has grown more than threefold. This growth has been amazing but posed challenges for us in keeping up with the demands that come with that success. Seeing how Cleveland Clinic manages its patient population of over 2,500 individuals helped me to find ways to apply a similar approach that will work for our team and allow us to successfully scale our program.

HCCInsights: What was Day One of the Practicum like?

Simpkins: I spent most of the first day with a nurse practitioner in the field going on house calls. My first impression of Cleveland Clinic’s program was that everything — systems, care, planning— seemed to be calm and seamless.

The technology used, including the software, also set the team up for success to best serve patients. It allowed the nurse practitioner I shadowed to be much more efficient because she was not constantly asking and answering questions through chats or over the phone, having to chart in another system, or needing to deal with connectivity issues.

It was also good to see how they managed one challenge associated with house calls that we previously faced – namely scheduling. We were giving our patients specific appointment times.  However, it’s difficult to correctly estimate the amount of time needed to treat cases while factoring in traffic and other unforeseen circumstances. This led to us often being late. The Cleveland Clinic team schedules appointments in four-hour windows, which gives the provider some breathing room.

And, most important, the patient care during the house calls was, in a word, “fantastic.”

HCCInsights: After the first day, it sounds like you had a good sense of Cleveland Clinic’s care model. What did Day Two offer?

Simpkins: I spent time in the practice’s office with an administrator learning about their systems, guidelines, safety protocol, and more. This body of work is the core of what makes them so successful and able to offer great care. The administrator I worked with was so giving of her time and very transparent, which helped me see the inner workings of their processes and procedures.

I also had the chance to get a good overview of their back-end practices, such as how a referral is sent, how they handle emergencies, and how they manage their monthly staff meetings and training schedules. I also saw how their nurses triage patients over the phone to determine if they need to go to the hospital or can be cared for by an HBPC provider. Plus, I learned a lot from their billing team about their practices.

HCCInsights: What were you surprised to learn during the Practicum?

Simpkins: One of the most surprising, yet incredibly useful, things I learned about, as I mentioned previously, was their block scheduling in four-hour increments. In the past, we had many patients refuse appointments because the proposed times didn’t work for their schedule. Cleveland Clinic sets visit expectations with their patients from the beginning. It was clear that block scheduling benefits both patients and providers.

HCCInsights: Were there any learnings from the Practicum you were able to implement right away in your practice?

Simpkins: Yes, we started reviewing some of our procedures right away, like our safety guidelines, and began to apply what I learned. We have also continued to implement the teachings from the Practicum throughout the year. For example, right now, we are working to move nurses away from scheduling so that they can focus solely on clinical work.

HCCInsights: What would you tell future Practicum participants?

Simpkins: The program is very worthwhile no matter what stage of practice you are in – because the activity is very individualized. For example, if you are currently offering HBPC, it gives you an opportunity to improve. If providing home care is new to you, you can begin with strong principles and practices from day one.

____________________________________________________________________________

To learn more about the HCCI House Call Practicum™ program and/or register, click here. There’s also an optional one-day Telemedicine Elective shadowing opportunity, also presented by Cleveland Clinic, that can be added on to the two-day Practicum, or attended on its own.

Categories
HCCIntel Practice Management Tip of the Month Training Training & Education

How to Confidently Get Reimbursed for Prolonged Services (Non-Face-to-Face)

Medical Billing and Coding

Since January 1, 2017, the Centers for Medicare & Medicaid Services (CMS) has authorized payment for CPT codes 99358 – 99359 for prolonged services non-face-to-face (F2F). When used correctly, this is a significant reimbursement opportunity for Home-Based Primary Care (HBPC) providers.

The CMS national payment rate for 99358 is $113.52 (the rate for 99359 is $54.78) with a Relative Value Unit (wRVU) of 2.10. This provides payment for the extensive medical management that occurs outside of the F2F visit. Although the use of these codes offers financial benefits, many practices continue to have concerns and/or questions regarding the services, leading to these codes being underutilized.

To help you receive the appropriate amount of reimbursement for the work your providers are doing under these codes, review the below requirements and apply them when appropriate:

  • The provider’s work is payable for both the office and outpatient setting (e.g., home or domiciliary visits, hospital, and nursing facility).
  • Time guidelines:
    • The billing physician or other qualified health care professional must spend a minimum of 31 minutes beyond the typical F2F time associated with the service as time directly related to an Evaluation and Management (E/M) F2F visit.
    • This time must be beyond the usual service time a provider would spend with the patient.
    • The provider must document why the service went above the normal time and effort.
    • The non-face-to-face time may occur on the same or a different date (i.e., before or after the visit) as the E/M F2F visit, if the documentation references the primary service it’s related to.
    • The exact amount of time spent must be documented in the medical record; the time does not need to be continuous (e.g., 20 mins in the AM and 15 mins in the PM), however, it must occur on the same calendar date.
    • The total time cannot be a compilation of times added together from various calendar days.
    • The service provided cannot be reported for time spent in non-face-to-face care described by more specific codes having no upper time limit within the CPT code set.
    • CMS notes that, while the typical CPT threshold times are not required for billing prolonged services, it is expected that only time spent in excess of these times is to be reported under CPT codes 99358-99359.
    • Per the CMS Claims Processing Manual, start and stop times are required for documented time (Page 83 of the manual: The start and end times of the visit shall be documented in the medical record along with the date of service).

In summary, your documentation should include start and stop times that show a minimum of 31 minutes spent on time directly related to an E/M visit. If the time occurred on a different date than the visit, you must reference the date of the F2F service and include a brief description of how that time was spent (e.g., nature or topic of what was reviewed or discussed).

In addition, CPT codes 99358-99359 cannot be reported during the same service period as the following due to similarity in service. As of 2020, however, prolonged services will be unbundled with transitional care management services, meaning they can be reported within the same calendar month:

  • Chronic Care Management (CCM)
  • Transitional Care Management (TCM)
  • Care Plan Oversight (CPO)
  • Anticoagulation Management
  • Medical Team Conferences
  • Online Medical Evaluations

For additional reference, the National Government Services (NGS) offers the following examples of appropriate uses of CPT codes 99358-99359:

  • Extensive medical record review directly related to an F2F encounter
  • Extensive telephone time with the patient and/or family that directly relates to an E/M encounter
  • Family/caregiver meeting, even without patient involvement but directly related to an F2F encounter

While these guidelines may seem challenging, you can tackle them by creating a Macro within your Electronic Health Record (EHR) that your providers can use for documentation purposes. In addition, you can create a back-end charge review rule to ensure the work does not get billed out during the same calendar month as other bundled services.

The time you invest in understanding these guidelines will assist in exponentially growing financial benefits for your practice.

Reference: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM9905.pdf

Categories
Benefits of HBPC Event HBPC in the News HCCI in the News HCCIntel Training & Education

International Workshop Shows How Small the World Really Is

GSA 2019 International Workshop on Home Care Medicine

GSA 2019 International Workshop on Home Care Medicine

On Friday, November 15, over 45 professionals in the field of gerontology attended the first-ever International Workshop on Home Care Medicine in Austin, Texas, as part of the Gerontological Society of America’s (GSA) Annual Scientific Meeting. The GSA describes itself as “the oldest and largest interdisciplinary scientific organization devoted to the advancement of gerontological research, learning, and practice.”

Recognizing the need to expand the “home care medicine conversation” globally, GSA invited the Home Centered Care Institute (HCCI) and American Academy of Home Care Medicine (AAHCM) to develop and co-lead the workshop. The session brought presenters together with participants from countries around the world, including Canada, China, France, Italy, Japan, the Netherlands, Spain, and the United States.

Aaron Yao, PhD, lead researcher for HCCI and Cheeloo Scholar Professor at Shandong University in China, played a key role in organizing the workshop. The program was designed to present recent trends and developments in home care medicine, facilitate the building of strategic partnerships to address global challenges, and provide an opportunity for peer networking.

The workshop was made up of four panel sessions featuring participants from different countries and allowed for extensive Q&A. The four panel themes were Service Delivery and Interprofessional Care, Technology (Mobile Diagnostics, EMR) in Home Care, Payments and Revenue Models, and Workforce Education and Training.

When asked what stood out most for him about the program, Yao answered, “The workshop’s message to me was simple but powerful – that aging has no borders and that great minds think alike.”

Melissa Singleton, Chief Learning Officer, HCCI, also found unique value in the event, “Having the chance to hear people from around the world talk about this growing and much-needed field of medicine reminded me of how very much alike we all are. Of course, each country has its own methodology, such as how they train providers, their payment models, and so on. But, even with that, finding our commonalities and sharing best practices make the world a little smaller, the challenges more manageable and the opportunities for collaboration even greater.”

The GSA workshop was not HCCI’s first appearance on an international stage. A little over a year ago, Yao facilitated an invitation for Dr. Thomas Cornwell, Chief Executive Officer of HCCI, to teach at the Shandong University School of Healthcare Management. Since then, much of HCCI’s curriculum has been translated into Chinese, and a total of 1,250 Chinese providers have been trained by HCCI faculty. The recent collaboration for GSA was an opportunity to bring Dr. Cornwell and HCCI back together with colleagues at Shandong University, as well as to meet new leaders in the field from around the world.

Categories
Caregiver Stories Event HCCIntel Uncategorized

Giving Begins at Home

“All those who provide care and comfort to people in their homes are privileged to witness the many ways in which ‘giving’ is expressed through families, caregivers, colleagues, and patients themselves,” offers Heather Hutchison, Chief Development Officer of the Home Centered Care Institute (HCCI).

As the holiday season approaches, we will be asked to give through our time and talents — and financially. GivingTuesday, a global day of giving, helps to remind us that we can give to a purpose, a cause, that reaches well beyond ourselves, like home-based primary care (HBPC). HBPC’s purpose is to care for those who are homebound or home-limited and this cause, by its very name, begins at home.

In the spirit of GivingTuesday, HCCI would ask you to share your stories of giving with us (while keeping HIPAA standards in mind, of course) so that they might be shared with others. It’s as easy as sending an email to [email protected] with “Giving Begins at Home” in the subject line. To inspire us all, we will consider these stories for sharing in our upcoming newsletters and through social media with the hashtag #HCCIgivingbeginsathome.

If you’re moved beyond the sharing of a story to support HCCI with a charitable gift for GivingTuesday, we would be grateful. Simply click here to make a donation that will make a real difference to patients and families who need us most, including educating providers and practices who bring health care to their homes.

Your meaningful and moving stories will remind us of the needs of others. Whether that story is about a caregiver being vulnerable enough to share their challenges with their visiting physician or nurse practitioner or about a patient expressing heartfelt gratitude to their caregiver.  Whether it’s about climbing three floors to visit a patient or listening to a story that’s been told many times before. A hand stretched out, a shoulder leaned on, a smile that warms the heart. All of these are stories about giving, stories that touch the lives of HBPC providers, practice leaders and operations staff.

“Wonderful and meaningful stories about giving are prevalent in our everyday lives and in the lives of those for whom we care,” added Hutchison. “We reflect on those stories for their inspiration. Yes, giving comes in many forms.”

Happy GivingTuesday!

 

Categories
HBPC in the News HCCIntel Legislative News Practice Management Press Releases

CMS Announces Request for Applications for Primary Care First Model Options

CMS Request For Applications

CMS Request For Applications

CMS Announces Request for Applications for Primary Care First Model Options

(Highlights for Consideration included below)

CMS released the Request for Applications (RFA) for the Primary Care First (PCF) and Seriously Ill Population (SIP) models last Thursday, October 24. The practice application period also started that day while the deadline to apply via the live portal is January 22, 2020.

The model will now begin in January 2021 (a delay of one year from the originally anticipated start date). CMS will select practices and payers during Winter/Spring 2020 and will onboard participating practices and payer partners to the model from July to December 2020.

Following are important highlights of the new program for practices to consider:

Fees and Measurements

  • Under PCF General, the primary care flat visit fee will be reduced to $40.82.
  • HCC Risk Group 4 will be the highest-level risk group with a payment of $175 Per Beneficiary Per Month (PBPM).
  • Practice risk groups 3 and 4 will not use the acute hospitalization performance measure; instead, performance for these groups will be measured on the Advance Care Plan and Total Per Capita Cost (TPCC).

SIP

  • SIP practices are expected to have an 8-month management and transition period for stabilization of their patients and then to transition them back to another primary care setting or practice.
    • This is known as the average length of attribution (LOA).
    • If the 8-month term is exceeded, a $50 PBPM reduction will apply to the monthly SIP payment through a quality adjustment.
  • SIP patients will require a face-to-face visit once every 60 days for them to remain attributed to the practice.
  • SIP payment redesign now states that after a practice conducts its initial face-to-face visit with the SIP patient, CMS will make a one-time payment of $325. With PCF, beginning the month following the initial visit, the practice will receive a $275 PBPM minus a $50 quality withhold that can be earned back with a potential quality bonus at the end of the first performance year.
  • SIP practices must describe the service area(s) in which they are interested in participating using zip codes and must define the maximum number of SIP patients the practice has the capacity and capability to manage.

Participation and Eligibility

  • Practices participating in the Independence at Home (IAH) Demonstration are eligible to participate even if it is not offered in the region(s) of the IAH practice.
  • Practices participating in the Comprehensive Primary Care Plus (CPC+) model cannot participate in 2021, however, they can participate in 2022.
  • Concierge practices, Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) are not eligible to participate.
  • Eligible practitioners are those practicing in internal medicine, general medicine, geriatric medicine, family medicine and/or hospice and palliative medicine.

Home Centered Care Institute Support

If you have questions about these changes or other home-based primary care questions, you can contact our HCCIntelligence™ Resource Center Hotline at 630-283-9222, 9:00am to 5:00pm (Central Time) Monday through Friday – or email us at [email protected]. The hotline and additional offerings in the Resource Center, including monthly webinars, virtual office hours, and tools and tips sheets are available at no charge due in part to a grant from The John A. Hartford Foundation.

 

Categories
Event Events HCCIntel

HCCI participates in “special” C-TAC Summit on Advanced Care

C-TAC National Summit
Photo credit: Bear Gutierrez

There was something special about the National Summit on Advanced Illness Care held October 9-11 in Minneapolis, as the participating members of the Home Centered Care Institute (HCCI) quickly learned. That “something” was a mixture of collaboration, a continuous improvement mindset and a passion for the patient. A passion found in the meeting’s theme of “Lead. Innovate. Inspire.”

The summit, hosted by the Coalition to Transform Advanced Care (C-TAC), and sponsored by several organizations, including HCCI, brought together hundreds of providers, practices, organizations, innovators and thought leaders. Over the three days, the participants took part in presentations and panels, interactive “labs,” breakout sessions, exhibits and countless opportunities for networking.

One of the most compelling discussions at the Summit was between Jon Broyles, executive director of C-TAC, and “patient champion” Shirley Roberson, who shared her Blue Chair story focused on the critical importance of listening to, and honoring, a patient’s voice.

The summit also saw Broyles announce C-TAC’s new “moonshot” goal centered on providing millions of seriously ill patients with a high quality of life by 2030. (Learn more about what a moonshot goal is here.) In sharing his thoughts on the goal, Broyles explained, “Quality of life is the ultimate outcome we’re all seeking, not just during serious illness, but throughout our lives. The challenge is that each person defines it differently. We have to figure out how to quantify it because we must be accountable to Shirley and millions of others, and because groups like CMS [The Centers for Medicare and Medicaid Services] will need a formula to measure it.”

Where’s a good place to start with that definition of “quality of life”? According to Broyles, it’s asking ourselves what makes a good and joyful life, and what is the purpose of all the things we do, like going to work, getting married, having hobbies, and so forth? Then, he adds, we must ask that same question of each patient to see how they define it.

As with all big goals, Broyles discussed the fact that this is just the first iteration of the “moonshot” goal, and that the specifics, including the number of lives touched, could change over time. But, he explained, “It’s important to not only focus on the big numbers. If we only focus on the ‘millions,’ that can be too big, too overwhelming to understand and to really change behaviors. Instead, we at C-TAC say, ‘Millions start with one.’ What can we do to change one life? From that, others will follow.”

When asked how C-TAC and HCCI can work together, along with the other organizations in the advanced care space, to “focus on the one,” Broyles answered, “We’re all facing a significant human and societal challenge, where the need will so far outpace what individual groups can do, that we have to figure out how to do it together. We must be open to new ideas, while building on what’s working now. This includes thinking about the role that caregivers, volunteers, communities, employers and others play in supporting each patient.”

Focusing on the importance of taking into account the patient’s perspective in this collaboration, Broyles added, “We need to understand how patients experience care and view quality of life along a continuum. Then, all the providing groups, whether it’s palliative care, hospice care, home-based primary care or other models of care, must work together to create a seamless experience for the patient. The goal is an experience where patients’ needs are anticipated and met, without them having to do extra work or perform extra coordination to make it happen. After all, they have enough to think about and do.”

Reinforcing this focus on collaboration, HCCI presented a well-received video, entitled “The Intersection of Home-Based Primary and Home-Based Palliative Care.” In the video, Dr. Thomas Cornwell, CEO of HCCI and founder of Northwestern Medicine HomeCare Physicians, shared that, “Home-based primary care can add significant value to an existing home-based palliative care program. This effort can include providing education and technical assistance to palliative and hospice programs and the patients they serve.”

Watch for more information in future HCCI newsletters on how HCCI will be working together with C-TAC and other key partners to make person-centered care a reality for more of those who need it.

Categories
Event Events

Blueprint for Success: Building and Growing Your Home-Based Primary Care Practice

Strategy Meeting

Blueprint for Success:
Building and Growing Your Home-Based Primary Care Practice

Friday, February 7– Saturday, February 8, 2020
Sheraton Crescent Hotel, Phoenix, AZ

Save-the-date to learn strategies for planning and operating a successful and sustainable home-based primary care practice!

Topics covered include personal readiness, managing change, creating a budget, deciding whether to outsource business services, ­­­staffing models, geographic scheduling, documentation and coding, straddling between fee-for-service and value-based environments, a telemedicine-EMR users’ panel, and interactive exercises that put it all together.

This conference is ideal for all providers and operations staff!

More information will be available soon at HCCInstitute.org or NNPEN.org.

Categories
HCCIntel Practice Management Tip of the Month

Chronic Care Management: One Way to Maximize Fee-for-Service Reimbursement

Nurse checking patient's blood pressure.

Would you like to maximize your reimbursements by up to $42 dollars per patient per month for the care being provided? Chronic Care Management (CCM) involves much of what you may already be doing to provide high-quality care for your patients: maintaining a comprehensive electronic care plan, managing transitions, and coordinating care with other professionals within and/or outside of your practice. The good news is that with a basic understanding of Chronic Care Management (CCM) documentation and billing, along with an effective workflow process, you can be fairly paid for providing these valuable services!

In 2015, CCM became separately payable by Medicare; however, it is still underutilized by many providers due to concerns about the documentation requirements or simply because providers don’t understand how this could easily become part of their practice’s workflow.

One concern has been that although many Electronic Health Record (EHR)  systems allow providers to turn on a CCM module for time tracking and other features, it is typically an extra expense to the practice. Many providers find that just by enhancing their knowledge of CCM requirements and by implementing some standardized processes, a CCM module isn’t always needed.

Let’s start with the basics of what qualifies a patient for CCM:

  • Two or more chronic conditions, which are expected to last at least 12 months, or until the death of the patient.
  • Chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline.
  • Comprehensive care plan established, implemented, revised, or monitored.

The medically complex and homebound will all qualify for these services, and home-based primary care (HBPC) practices provide extensive care coordination and management services to their patients. It is pretty typical for providers and clinical staff to spend at least 20 minutes per calendar month to manage their patients’ medical and psychosocial needs.  So why not be reimbursed $42.84 (2019 CMS National Payment Amount) per patient per month? Only 20 minutes of combined clinical staff and providers’ time per calendar month is required to bill for CPT 99490 Chronic Care Management.

If your physicians or other qualified health care professionals (Nurse Practitioners, Physicians Assistants, Certified Nurse Midwives, and Clinical Nurse Specialists) are personally spending a complete 30 minutes within a calendar month addressing the medical and care coordination needs of their complex patients, then you can bill CPT 99491 which pays $83.97 (CMS National Payment Rate).

One potential barrier or source of confusion practices may feel limits their ability to provide CCM services to their patients is how to develop the CCM Comprehensive Care Plan that must be created, monitored, implemented, and provided to patient’s and/or caregivers receiving CCM services. Don’t let this stop you; consider if you have a nurse or other clinical staff that could be designated to support CCM and assist the providers in creating these care plans for patients. Below is an example that contains the care plan fields, which meet CMS requirements.

  • Problem List
  • Expected outcome or prognosis
  • Patient Goals of Care
  • Treatment Plan for each Chronic Condition
  • Symptom Management Plan/Education Resources Provided
  • Care Team (Include roles & responsibilities)
  • Medication List (Mark as reviewed/reconciliation last completed date)
  • Community and Social Services Involved in Care (include role and frequency of interventions)
  • Care Plan Review Date

What other elements are required when providing CCM services to your patients?

  • You must obtain and document either verbal or written consent for the patient to receive CCM services, and only one billing practitioner may provide and report CCM services per beneficiary.
  • Structured Recording of Patient Health Information: Practice utilizes certified EHR technology.
  • Access to Care & Care Continuity: Enable 24/7 access to provider team and other clinical staff with a means for after-hours coverage, designated relationship with a member of the care team, and provide enhanced communication opportunities.
  • Comprehensive Care Management: Systematic assessment/monitoring of all medical, functional, and psychosocial needs, medication reconciliation with review of adherence, potential interactions, and self-management, coordinate home and community-based services.
  • Transitional Care Management: Manage transitions as part of CCM.

For further explanation of the requirements in the CCM Comprehensive Care Plan refer to the following HCCI resource, CCM Care Plan Requirements.

Don’t let the list intimidate you! If you are currently providing longitudinal home-based primary care to your patients, chances are, you are already meeting the requirements but just not billing for it.  This means you could be leaving a significant amount of revenue on the table. To put this in perspective, let’s say you billed 300 traditional CCM charges within a six month period. That’s an extra $12,852 in revenue.

In today’s Fee-for-Service model, you must take advantage of all possible billing opportunities to be sustainable and properly reimbursed for the quality, compassionate care your team is already providing.

 

Categories
Event Events

Join HCCI at GSA 2019 Annual Scientific Meeting

GSA 2019

GSA 2019

Join the Home Centered Care Institute (HCCI),
the American Academy of Home Care Medicine (AAHCM)
and other global leaders as we present the first-ever
International Workshop on Home Care Medicine

Friday, November 15 | 8:00 a.m. to 11:30 a.m.
Austin Convention Center | Austin, TX

Through the International Workshop on Home Care Medicine, GSA offers the opportunity to learn the latest trends and developments from home care medicine leaders, build strategic partnerships to address challenges, and network with peers.

Panel 1: Service Delivery and Interprofessional Care (1 hour)

  • Aaron Yao, Research Director, Home Centered Care Institute and Professor, Shandong University, Panel Chair
  • Irina Jara Calabuig, Home Care Physician at Alzira´s University Hospital in Valencia, Spain
  • Theresa Soriano, Regional Chief Health Officer at Cityblock Health and President-elect of American Academy of Home Care Medicine, USA
  • Noriko Yamamoto-Mitani, Professor of Medicine at the University of Tokyo School of Medicine, Japan


Panel 2: Technology (Mobile Diagnostics, EMR) in Home Care (30 minutes)

  • Aaron Yao, Research Director, Home Centered Care Institute and Professor, Shandong University, Panel Chair
  • Zia Agha, Chief Medical Officer and Executive Vice President at WestHealth, USA
  • Dai Yumino, Chief Director of Yumino Medical, Japan


Panel 3: Payments and Revenue Models (1 hour)

  • Eric DeJonge, Chief of Geriatrics, Capital Caring and President of American Academy of Home Care Medicine, USA, Panel Chair
  • Laurence Nivet, Director and Matthieu De Stampa, Head of Medical Staff, HAH-Larger Paris University Hospitals (AP-HP), France
  • Tadashi Wada, Clinical professor at Irahara Primary Care Hospital, Japan


Panel 4: Workforce Education and Training (1 hour)

  • Thomas Cornwell, CEO and Founder of Home-Centered Care Institute, USA, Panel Chair
  • Sabrina Akhtar, Physician Lead of the Home-Based Care Program, Toronto Western Family Health Team, Canada
  • Takashi Yamanaka, Chair and Associate Professor of Home Care Medicine, University of Tokyo, Japan

 

learn more button