PES Has The Sustainable Solu2on For Chronic Care Management

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Lindsay Hortense Harper
9 years ago
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1 PES Has The Sustainable Solu2on For Chronic Care Management Empowering pa2ents to lead the management of their chronic diseases through a proven and effec2ve model of collabora2on with clinicians and caregivers.

of their chronic diseases through a proven and

2 PES is on a mission to improve the landscape of healthcare We make it easy and profitable for providers to deliver care to pa2ents, any 2me, anywhere. We simplify delivery of pa2ent care beyond the tradi2onal clinical sefng. We maintain pa2ent records using cer2fied EHR technology Our solu2on can be implemented in your organiza2on in as early as two weeks. No upfront costs or changes to your prac2ce workflow needed. 2

We simplify delivery of pa2ent care beyond the tradi2onal clinical sefng.

3 Chronic Disease by the numbers More than 75% 2/3 of US healthcare spending in on people with chronic condi2ons of Medicare beneficiaries had 2 or more chronic condi2ons About 1/3 had 4 or more chronic condi2ons 3

condi2ons of Medicare beneficiaries had 2 or more

4 Who can par2cipate? Only specific providers can bill for CCM services: Physicians Nurse Prac2oners Clinical Nurse Specialists Physician Assistants Cer2fied Nurse Midwives 4

5 Chronic Care Management Requirements The new Medicare CPT code allows billing for non face- to- face care management, for pa2ents with chronic condi2ons. Pa2ents with 2+ chronic condi2ons are eligible Care plan(s) must be made available electronically Care team must be available 24/7 Pa2ents must receive at least 20 minutes of non face- to- face chronic care management (CCM) per month Pa2ents must provide their consent and par2cipate in one provider s CCM program 5

Pa2ents with 2+ chronic condi2ons are eligible Care plan(s) must be made available electronically Care team must be

6 CCM Challenges Prac2ces would need to make substan2al investments and workflow changes to meet CPT billing requirements. Would need to dedicate a 24/7 nursing staff for phone care Would need to build technology to handle online care- plan access plus messaging for en2re care team Would need a billing system that provides 2me tracking for non face- to- face care delivery Would need to dedicate staff to calling and enrolling pa2ents in a chronic care management program Each insurance company has different billing requirements 6

messaging for en2re care team Would need a billing system that provides 2me tracking for non face- to- face care delivery Would need

7 THE PES Solu2on for CCM Turn- key chronic care management program No upfront costs or changes to your prac2ce workflow needed. Provide us with a list of pa2ents through your EMR solu2on, we ll iden2fy eligible pa2ents We call the pa2ents to enroll them in the program We provide 20+ min. of non face- to- face calls with our trained medical assistants Our 24/7 call center, based in Cambridge, MA, is staffed by trained medical assistants (a billing requirement) You receive weekly oversight reports and have full access to our pa2ent interac2ons We help you bill Medicare for CPT 99490, with monthly automated reports We use specific HEDIS, QARR and CAHPS measures to evaluate the effec2veness of the care 7

of non face- to- face calls with our trained medical assistants Our 24/7 call center, based in Cambridge, MA, is staffed by trained medical assistants (a billing requirement)

8 What we offer An up- to date care plan shared with all your pa2ent s provders 24/7 online and phone access to medical assistants Handle all health data using HIPAA compliant soeware Access real- 2me date and monitor your enrolled pa2ents Easy to use web and mobile app for pa2ents, their family and caregivers Audit- able monthly reports required by Medicare Remote vitals monitoring via integra2ons with trackers and wearable devices Direct messaging for effec2ve informa2on exchange 8

Easy to use web and mobile app for pa2ents, their family and caregivers Audit- able monthly reports required by Medicare

9 THE Opportunity New revenue opportunity Between $15- $18 (depending on your area) per pa2ent per month for as long as the pa2ent is enrolled Example: If your facility has 100 Medicare pa2ents you can make $15,000 a month in PASSIVE INCOME We are responsible for the 20 minutes of monthly non face- to- face communica2on that Medicare requires in order for billing to be generated 9

pa2ents you can make $15,000 a month in PASSIVE INCOME We are responsible for the 20 minutes of

10 Results to date Reduc2on in A1C levels Member sa2sfac2on up by 4X compared to pa2ents outside of CCM Maintain <.001% of unplanned admissions Timeliness of care transi2on no2fica2on of the receiving care sefng from the sending sefng 96% of Medica2on adherence Improved ac2vity, nutri2on and lifestyle improvements 10

001% of unplanned admissions Timeliness of care transi2on no2fica2on of the

11 Effec2vely Change the Way Your Pa2ents See YOU 11

12 Create a new stand- alone revenue opportunity while providing best individualized care services to your pa2ents. 12

eclinicalworks CCM- Chronic Care Management Program Introduction

eclinicalworks CCM- Chronic Care Management Program Introduction CCM- Chronic Care Management Program Introduction CCM- The Context Financial & Human Cost of Chronic Conditions 70% Deaths 67% Chronic Patients 98% Hospital Readmissions 93% of Spending Medicare Solution