by John Zulaski, President, Practice Management
Practice Management is a participating partner in the Center for Medicare and Medicaid Services (CMS) Connected Care program, promoting the value and benefits of Chronic Care Management (CCM) services. We seek to help bring providers and patients a valuable service. Providers engaging CCM services benefit from significant financial incentives, improved outcomes, and the potential to reduce administrative burdens. Patients benefit thru consistent contact with the care team directing them to needed resources such as their healthcare provider and to direct them away from harm.
As the challenge of providing these additional services in-house has been examined, a strong need for assistance has been identified by many companies specializing in CCM. Challenges include hiring and managing productivity. The biggest challenge is to meet the 20 minute requirement for 90% or more of enrolled patients.
The outsourced CCM is an elegant solution that is being rapidly adopted by healthcare providers large and small. Most companies offer a software solution or a fully staffed CCM team. While many provider organizations feel the best solution is to perform the task in-house, the delay while building and training the CCM team may be costly. Delay means months going by with no service performed, and no revenue. A viable plan that doesn’t leave money on the table might be to start with the full service option and transition to in-house at a comfortable pace.
Costs of these services range from 50-65% of the per patient per month reimbursement with the remainder left as practice profit. Once the program is up and running, there is very little for provider offices to do except to help patients enroll (generally by verbal consent). The financial impact can be substantial given that most Medicare patients meet the requirement of two chronic conditions. A practice with just 10,000 Medicare patients participating monthly (and only performing the basic 20 minute service) would see $140,000 to $200,000 per month after paying the outside CCM service. That’s $1,680,000 to $2,400,000 per year!
CMS continues to roll back barriers to participation in an effort to invest in the savings that CCM is expected to generate. Could CCM benefit your patients?
October 25-27, 2017
NACHC 2017 Financial, Operations Management/IT Conference (FOM/IT)
Planet Hollywood, Las Vegas, NV
Practice Management recently exhibited at the 2017 National Association of Community Health Center’s Financial, Operations Management /Information Technology (FOM/IT) Conference in Las Vegas, October 26-27, 2017.
The FOM/IT Conference attracts more than 700 health center CEO’s, CFO’s, COO’s, CIO’s and health center finance, operations and IT staff from around the country who are seeking best practices and innovative solutions to their most pressing challenges. The FOM/IT conference is the best place for health centers to connect with their peers, leading experts from the field, and prospective partners to identify key strategies and tactics and to share best practices and lessons learned to optimize their health center for financial and operational success.
The state has selected BlueCross BlueShield of Illinois, Harmony Health Plan, IlliniCare Health, Meridian Health Plan, Molina Healthcare and CountyCare Health Plan to participate for the next four years.
Click here for the complete Chicago Tribune article.
This article includes the latest tests approved by the FDA as waived tests under CLIA. The Current Procedural Terminology (CPT) codes for the following new tests must have the modifier QW to be recognized as a waived test. However, the tests mentioned on the first page of the attached list (that is, CPT codes 81002, 81025, 82270, 82272, 82962, 83026, 84830, 85013, and 85651) do not require a QW modifier to be recognized as a waived test.
Click here for more information from CMS.
By John Zulaski, President, Practice Management
Collecting from patients is a difficult and frustrating process with medical debt often cited as the number one cause of personal bankruptcy. Successful in-house collection is problematic and often impossible. The problem frequently lies in the fact that patients simply have limited ability to pay. Financial demands on the average consumer bombard your patients constantly. While the patient may have had the $50 to pay you yesterday it may no longer be available today. Time is precious when it comes to collecting from patients.
Let’s face it; we live in a world where demands for consumer’s cash appear at every turn. U.S. marketing to consumers focuses on making life better; all you have to do is purchase the next product or service to get your trip to nirvana. On the other hand, medical bills are for services already provided often with negative connotations such as sickness, injury, and problems. After the rent, cable and cell phone bills are paid the stack of medical bills is considered. Healthcare organizations cannot compete with the demands for cash our society places on the average patient. If you do not collect when the patient is in the mood to pay, you risk not collecting at all.
With those barriers in place, we need to make it as easy as possible to collect from patients who may have the impulse to pay. We cannot put barriers up that make payment more difficult.
Every possible avenue for easy access to payment needs to be open. All major cards need to be accepted, electronic checks, cash, etc. Yes, you need to take AmEx, weigh the cost of service fees against the 85% or more loss if you don’t take the payment when the patient is in the mood. Payment methods need to be easily accessed with the fewest hurdles by phone, by web, or in person.
The “Pay My Bill” button on your website needs to be in a prominent position.
Figure out a way to accept web payments without having the patient set up a login.
Take payments from anyone offering. HIPAA should not throw a barrier up when the spouse who handles the bills wants to set up a payment plan for their partner.
Make sure all support staff can take an immediate payment when the patient makes the attempt.
Set simple policy for accepting payment plans, offer prompt pay discounts, and offer discounts to resolve very old balances.
Make the policy simple enough to give authority to as many staff as possible.
The cost of discounts and payment plans can be weighed against the loss of uncollectible debt. Could a 50% or 70% discount vs. 100% write-off be a better financial deal for the healthcare provider? Does it make sense to offer huge goodwill discounts on longstanding debt rather than fighting to the finish at a third party collection agency? Maybe… An open mind and open access are needed to address the most difficult area of healthcare finance.
October 18-20, 2017
IPHCA 2017 Annual Leadership Conference
Grand Geneva Resort & Spa, Lake Geneva, WI
Practice Management will be exhibiting the 2017 Illinois Primary Health Care Association’s Annual Leadership Conference in Lake Geneva, WI, on October 19, 2017.
The Illinois Primary Health Care Association (IPHCA) is a nonprofit trade association of community health centers (CHCs) that proudly serves as Illinois’ sole primary care association. IPHCA strives to improve the health status of medically underserved populations by fostering the provision of high-quality, comprehensive health care that is accessible, coordinated, community-directed, culturally sensitive, and linguistically competent. IPHCA represents Federally Qualified Health Centers (FQHCs) or community health centers—entities created by Congress to meet the health care needs of underserved communities and high-risk patients. These centers fill a void by providing care for those whom other providers often do not serve.
“Court order should improve managed Medicaid payment turnaround here in Illinois.”
Click here to read the full Sun-Times article.
On August 27–29, Practice Management exhibited at the 2017 Community Health Institute & Expo as part of the National Association of Community Health Centers (NACHC) annual conference. Held at the Manchester Grand Hyatt in San Diego, the 3-day event is the largest and most significant annual events that brings together over 2,000 community health center managers, clinicians, board members and leaders.
The NACHC 2017 Community Health Institute (CHI) covered important topics related to health centers and transformation of healthcare. Health center leaders are looking to the future focused on the medical and management teams needed for tomorrow’s healthcare – the collaborative partnerships that can spur innovations – and the technologies to improve efficiency and cost effectiveness in the delivery of care.
What to Expect
The CHI will position health centers for sustained leadership in the coming years. Participants will hear NACHC leadership, government officials, healthcare industry leaders and other special guests speak to the challenges and opportunities that lie ahead, including up-do-date information on policy shifts, federal regulatory changes, funding and proposed legislation. The national conference will foster opportunities for health center professionals and consumer board members to network, share perspectives and best practices, and stay competitive and relevant in the healthcare marketplace. A host of educational sessions and events will be offered on major topics relevant to the operations and governance of health centers.
Every aspect of the community health center movement is represented at the CHI expo, making it an excellent networking opportunity for many professionals in the industry. In addition to networking, attendees can learn new skills, discover new ideas and solutions, and explore the latest information from industry thought leaders.
May 11-12, 2017
AllianceChicago 2017 Annual Conference
Holiday Inn Chicago Mart Plaza River North, Chicago, IL
Practice Management recently exhibited at the AllianceChicago 2017 Annual Conference in Chicago, May 11-12, 2017.
AllianceChicago improves personal, community and public health by focusing on health care collaboration, Health lnformation Technology (HIT), and Health Research and Education. Erie Family Health Center, Heartland Health Outreach, Howard Brown Health Center and Near North Health Service Corporation came together to explore ways to share resources in support of their common missions. Early in their history, the founding partners elected a strategic focus on Health Information Technology (HIT), and formed Alliance of Chicago Community Health Services, now AllianceChicago Health Information Technology. AllianceChicago HIT has been expanding and innovating to meet the diverse and ever-evolving health care needs of vulnerable populations, while proactively responding to the changing health care climate.