Chronic Care Management Benefits For My Practice

• Your patients’ health may substantially increase; hence, your customer service and patient satisfaction will improve, your reputation will be even better, allowing you to grow your practice more.
• Phone calls from your CCM patients will drastically reduce, allowing your Call Center or Front Desk to focus on other tasks, at the same time your Medical Assistants won’t have to answer as many questions.
• Your no-show and cancelation rates will decrease, allowing you to schedule and see more patients.
• Your patients will be assisted with completing imaging studies, lab work, and referrals for other doctors, having their documentation up to date, and your staff would not need to fetch for reports, results, and notes. The result is having more efficient visits, again, improving customer service along with patient satisfaction.
• At the moment you may be doing most of these tasks but you are not getting reimbursed from them, with CCM you will be reimbursed.
• CCM will help your practice to comply with QPP’s Merit-Based Incentive Payment System (MIPS).

Here’s What’s Happening

Local Medical Clinic Administers Thousands Of Flu Shots

Karen L. Smith, MD, FAAFP shares her experience with offering Chronic Care Management (CCM) services to her Medicare patients in a rural North Carolina community. Watch this short video to learn more about the benefits of providing CCM to patients living with multiple chronic conditions. Visit go.cms.gov/ccm to learn more about the Connected Care campaign and get resources you can use to educate your patients about CCM.

---

Assessing Your Alternatives when Implementing CCM

By Xavier Hugo Escobedo

So, you have decided to implement a Chronic Care Management (CCM) Program in your practice. What is the next step? Do you implement it on your own, do you hire a consultant to do it for you, or do you hire a third party to outsource support services? This article sheds light into the 6 business components every practice should consider when implementing CCM and based on this, help you in choosing the alternative that may work best for you. We’ll analyze knowledge, time, money, technology, organization and workload; from the financial, HR, compliance, project management and patient satisfaction/customer service perspectives.

 

According to the final report from Mathematica ™ Policy Research on Evaluation of the Diffusion and Impact of the Chronic Care Management Services (1), doctors and managers perceived positive results for CCM patients, improved patient satisfaction, improved clinician efficiency, and decreased hospitalizations and emergency room (ER) visits. In the same report, several providers noted that the value of CCM services received, far exceeded the cost. This means that if you have decided to implement CCM, you are in the right path to offering overall a better value to every party involved.

For a successful implementation, the following elements are essential: strategic planning, communication, resources, and people (2). This list was developed by Project Times™. These elements can be translated within a CCM implementation into 6 components: knowledge, time, money, technology, organization, and workload; sometimes overlapping each other.

 

Going Solo

For many doctors and practice administrators going solo has been their choice. When implementing CCM on your own you need to allow for plenty of time to plan and develop the project and to set up processes and procedures. You will need to hire for or assign the right staff to the new positions. You will need to have the right technology in place; but before that you should demo the software available on the market. You may perhaps want to develop your own CCM tool. Putting all these elements in play require a financial and time investment. Time is money, knowledge is money, technology requires money. An honest self-assessment of your practice’s organization dynamics is required. It can be hard to measure, and sometimes even harder to recognize whether your team is capable of juggling all the new pieces that go into CCM. Finally; paired with investing resources in the new CCM project, it is critical to maintain the daily practice operation, which is the core of your business.

For a well-established practice that has policies, procedures, quality measures and controls already in place, and that consistently attains high rates of patient satisfaction and low wait times; an inhouse CCM operation may be an excellent way to go.

 

Hiring a Consultant

Career service and career advice company, The Muse, lists the following as reasons on why companies really hire consultants: they want an outside eye, they need extra horsepower, they want specialized skills, and they want a safe zone.

When hiring a consultant for CCM or for any other project, you are purchasing the precious time most professionals are hungry for, and you are buying the knowledge needed to implement a program.  The consultant has already researched technology and software and is able to advise on multiple options. Most practices have a heavy work load. Between seeing patients, billing for the rendered services, managing employees, complying with CMS and private insurance guidelines, and implementing MIPS changes; practitioners and managers struggle to keep up with work. Hiring a consultant is like riding the Space Mountain attraction at Disney using the FastPass: you get to experience the attraction at the fullest without the line, meaning implementing the program should be extremely easy.

 

Hiring a consultant is not hiring a magician. When you hire a consultant, the consultant needs time with you or your key personnel to tailor the solution to your needs and train your employees on the project. Once employees are trained and CCM is implemented, you still need to get organized in order to follow up and manage the employees involved in the project. Whether you are implementing CCM on your own or hiring a consultant, you still need to hire the right personnel to manage the project. Maybe you are considering training your existing employees but moving someone to this project will leave at least one empty position somewhere else. For the practices that understand CCM, that want full control of the program and that want to jump start the project and begin reaping the benefits as soon as possible; hiring a consultant is a great option.

 

Hire a Third Party-Outsourcing

When hiring a third party to manage your CCM project, it is important to understand the advantages and disadvantages of outsourcing this or any other process. According to ResearchGate, whose mission is to connect the world of science and make research open to all, the following are advantages and disadvantages of outsourcing (3):

Advantages	Disadvantages
·         Cost reduction ·         Time economy ·         Emphasis on core and strategic issues ·         Hidden costs clarification ·         Increased flexibility ·         Increased accountability ·         Quality improvement ·         Easy access to resources and skills ·         Gaining competitive advantage	·         Lose control ·         Further need for coordination ·         Further dependency on outside organizations ·         Risk

 

It is noticeable that there are more advantages than disadvantages. You may be thinking of the 6 CCM components that have been discussed in this article, and how they line up with the advantages when outsourcing. Let’s now focus on the disadvantages:

Because of the loss of control, you should only outsource processes that are not your core business. Given that CCM is a support process, outsourcing it does not mean losing control of your business itself. In the case of CCM, the core activity is coordinating patients’ care, so this actually negates the second disadvantage – coordination is the service being outsourced. Finally, depending on an outside organization for an activity that is not a core process will not jeopardize the activities you perform on a daily basis. The trade-off for that dependency is the increased accountability and flexibility that outsourcing provides.

Outsourcing a back-office process is almost always more cost effective than performing the same processes in house, and CCM is no exception. Outsourcing allows dedicated personnel to devote 100% of their time to your process, which leads to higher productivity. In house, your own personnel will likely have other existing duties (and perhaps with a higher priority level) to attend to and will have a higher learning curve than outside personnel who are already up-to-speed on the process and can hit the ground running. These factors mean that the hourly wages and payroll taxes of your own employees (the personnel performing the actual project, plus those performing quality review and supervision) will simply cost more than the rates you pay to outsource. In addition, consider the overhead cost for housing a new project. When done in house you may need to purchase additional workstations, software, phones, and dedicate floor space to a new project like CCM. Outsourcing removes the cost of all these additional resources.

What to do next? Was asked at the beginning of the article, now you need to answer the following questions:

• How much knowledge about CCM do I have?
• How much time can I allocate to implement and monitor CCM?
• How much money is required to get the program going and to sustain it?
• Do I know the existing technologies to implement the program, and do I have such technology?
• Am I organized enough to add a new project in to my To Do List?
• Will the current workload allow me to take on a new project?

The answer to these questions will determine if you go solo, hire a consultant, or use an outsourcing company to support you with CCM.

 

Sources:

(1)    Evaluation of the Diffusion and Impact of the Chronic Care Management (CCM) Services: Final Report. Mathematica Policy Research, November 2, 2017.

(2)    https://www.projecttimes.com/articles/5-essential-elements-of-a-successful-project.html

(3)    https://www.researchgate.net/figure/Advantages-and-disadvantages-of-outsourcing_tbl1_228637156

 

Xavier Hugo Escobedo is the Manager of DX Healthcare Services a Business Unit of DataXport.Net, LLC, a Certified Texas State HUB and Small, Woman, & Minority Owned Enterprise; specializing in Customer Contact Center Services, IT Managed Services and Electronic Medical Records Management.