Once a healthcare practice has decided they want to implement a Chronic Care Management (CCM) program, what to do next can be overwhelming. There are a significant amount of options in the marketplace varying from EHR modules, third party software, and fully-managed services. Without having managed a CCM program before, many are quick to assume they can do it themselves with the help of a software solution. Oftentimes, the evaluation criteria can seem as simple as a pricing difference between software vendors. What decision makers often fail to realize is how powerful the benefits of a fully-managed solution are… so powerful that it can be the difference between a failed program and a successful one. In this blog, we will explore some of the key benefits that a full service CCM program can provide versus a software solution.
We’ve seen claims of Chronic Care Management software supporting up to 500 CCM patients per care manager. At a minimum of 20 minutes of care required per patient, that’s 10,000 minutes, or 166 hours of care, required by one employee in a month. A full-time employee working 40-hour workweeks will only work an average of 160 hours per month. Therefore, it’s physically impossible for a single care manager to handle 500 patients on their own. Not to mention, an employee cannot work at 100% utilization every moment of the day.
Most practices who have run their own CCM program will tell you they struggled to achieve 100 CCM patients per care manager, per month. Those same practices will tell you they were unprepared to manage a call environment without significant infrastructure investments (telephonic systems, analytics, quality assurance, etc.) and an expected amount of redundant labor to cover the required 24/7/365 program requirements.
It’s important to note that labor costs do not stop at the clinical encounter. One of the largest and most necessary costs will be for the labor required to enroll eligible patients into the CCM program and committed data resources needed to manage the daily, weekly and monthly patient enrollment and churn inherent in Medicare and Medicare Advantage. Patient enrollment requires staff who are trained in patient marketing tactics such as providing rebuttals and articulating value propositions. Without this type of training and a commitment to reconciling enrollment data, your practice will not be able to maximize its enrollment rates. Because of the nature of patient churn, this is an ongoing necessary function.
With a turnkey care management program, your practice does not have to think about labor costs. A CCM service provider will supply all labor required. As more patients join your CCM program, your service provider vendor will supply more labor. If you select the right partner, there is no limit to how many patients your program can handle. At ChartSpan, we guarantee that our care team of clinicians will reach out to each of your patients, each month, and provide meaningful services to all of your enrolled CCM patients for a full 20 minutes each month, or you will not be billed. In addition, our enrollment team ensures multiple follow-up attempts to reach your eligible patient population for enrollment.
Patient marketing is a crucial part of a successful CCM program. A full service care management solution will provide your eligible patients with educational and marketing strategies at no additional cost, including but not limited to:
- Program awareness collateral
- Social media posts
- Educational awareness marketing
- Educational letters
- Educational email campaigns
- Custom recorded provider messages and voicemails
- Educational clinical materials
- Welcome packets for newly enrolled patients
- Monthly themed patient engagement emails
Without highly effective patient education and marketing, patients are less likely to enroll in a CCM program. Additionally, once they are in the program, if they do not understand the benefits or forget what they are, they are more likely to un-enroll. This is why it’s important to continually engage with the patient with education and marketing throughout the program. With a CCM software-only solution, you are unlikely to have this added function.
The technology needs of a successful CCM program are complex. Proper care coordination requires advanced telephonic infrastructure, quality auditing technology, and analytical BI reporting. Not only are there a vast amount of tools and systems needed, but each one has to have specific features that align with mandatory CMS compliance. Medicare has strict rules in place to keep CCM programs compliant. Your CCM program will require monthly auditing of calls to ensure all rules are followed. This requires special technology (not to mention, labor too). All technology that handles patient information or integrates with the Electronic Health Record (EHR) must be HIPAA-compliant, with encryption throughout. Patient care plans should be streamlined and pushed to the EHR so that no workflow is interrupted. Although some CCM software-only solutions offer a few of these technologies, they are often not as advanced as they are in a fully-managed solution.
A Personal Touch
Healthcare providers are rated by their bedside manner, so why shouldn’t your CCM program be? Your patients with chronic conditions have specific needs and deserve a personal touch, which means an empathetic and knowledgeable healthcare professional should be available to them at all times. Some CCM software platforms only use automated text messaging or AI to communicate with your patients. While this is a useful form of outreach in some situations, such as notifications, reminders, and transactional activity, it is not compliant or allowed functionality in the time spent providing CCM services to patients. Additionally, without a real person on the other end of the line, the quality of patient care greatly reduces.
If you’d like to learn more about the benefits of a CCM service provider, request time with one of our experts today.
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