Chronic care solutions primarily aim to improve patients’ treatment quality, drive positive outcomes, and provide financial value. Chronic care management (CCM) enhances treatment quality by providing necessary care and support, improving patients’ quality of life. And it helps patients stay on track with their treatment plans and offers CCM solutions that foster support and human connection.
This article explores the goals of chronic care solutions and how remote patient monitoring enhances care and grows revenue.
Chronic Care Solutions
Roughly 117 million adults have one or more chronic health conditions. At the same time, one in four adults have two or more. Therefore, CMS acknowledges that CCM is an essential primary care service that significantly improves patient health and care. Chronic care management encompasses coordination services that occur outside of regular office visits.
Chronic care solutions also drive positive patient outcomes by helping patients overcome challenges in following their treatment plans, reducing emergency visits and readmissions, and freeing healthcare resources. Additionally, CCM provides financial value by saving providers’ resources and reducing overall patient costs. For instance, RPM is highly cost-effective for hypertension and may achieve greater long-term cost savings from the prevention of costly health events.
What Conditions Qualify for Chronic Care Solutions?
To qualify for chronic care management services, patients must have two or more chronic conditions expected to last at least 12 months or until the patient’s death. The conditions must place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline. The Centers for Medicare and Medicaid Services (CMS) provide a complete list of qualifying conditions.
Some chronic conditions that qualify for CCM solutions include the following:
- Arthritis
- Asthma
- Chronic kidney disease
- COPD
- Diabetes
- Cancer (breast, colorectal, endometrial, lung, and prostate)
- Heart Disease
- Hypertension
- Neurological and mental health conditions
CCM Solutions vs. Remote Patient Monitoring
Chronic care services are conducted outside of regular office visits. They may include remote patient monitoring (RPM), patient education, medication management, care planning, shared decision-making, preventative services, and management of care transitions. The difference between chronic care management and remote patient monitoring is that chronic care management is a comprehensive approach to treating patients with chronic conditions. In contrast, remote patient monitoring is a technology used for monitoring patients’ health from a distance between appointments.
Remote patient monitoring devices, wearables, or mobile applications to gather and transmit patient data to healthcare professionals, enabling analysis and intervention. In summary, remote patient monitoring is one component of chronic care management. Combining both can benefit patients and providers.
Billing for CCM Solutions
By providing chronic care services, healthcare professionals ensure coordinated care and support for patients, helping them stay on track between visits. Generally, chronic care solutions do not require face-to-face visits. Still, eligible practitioners can bill for chronic care management and remote patient monitoring care coordination services each month. Physicians, physician assistants, clinical nurse specialists, nurse practitioners, certified nurse midwives, federally qualified health centers, rural health clinics, and critical access hospitals can bill for CCM services. However, only one practitioner per patient can be paid for monthly CCM services.
In addition, CMS recognizes that remote patient monitoring is a valuable form of healthcare delivery for chronic care patients. Therefore, chronic care patients are eligible for both remote monitoring and chronic care solutions. While RPM services are available for all CCM patients, not all patients qualify for chronic care solutions services.
Increased Revenue with Remote Patient Monitoring
Remote patient monitoring does not have any restrictions on where the patient is located, making it accessible to a larger number of patients. Moreover, not all RPM services must be directly performed by the billing physician. For instance, CPT 99457 can be billed under general supervision, allowing Medicare providers to contract third-party vendors for assistance with RPM services. This approach enables clinics to efficiently manage more patients and increase their revenue without significantly impacting their workflows.
An example of the benefits of RPM can be seen in the case of a large Federally Qualified Health Center. By adopting telemedicine, they experienced a reduction in missed appointments, resulting in significant cost savings. These savings were further enhanced by implementing a support team that conducted pre-visit device and connectivity testing. The total monthly revenue from averted missed appointments amounted to $45,578.
Chronic Care Solutions and Tenovi Remote Patient Monitoring
Tenovi RPM devices and the CCM billing platform offer customized chronic care solutions for chronic care companies. Our FDA-cleared remote monitoring devices, physician dashboard and billing platform provide an efficient and cost-effective option for chronic care management. Please request a free demo to learn more about how we can help your organization achieve its care management goals.
