Choosing the right chronic care management company can help healthcare organizations provide more consistent support to patients between office visits. CCM is more than making periodic phone calls to patients. Effective programs involve a coordinated care program, consistency of communication, collaboration among health care providers, management of medications, and timely access to care. If a clinic does not have adequate personnel and/or in-house systems to run these activities efficiently, an experienced chronic care management companies can supply the technology, personnel, and workflows to run the program.

What Do Chronic Care Management Companies Do?

CHRCM companies assist healthcare providers with providing the chronic care services a patient requires. Care workers can provide support in various forms depending on the company and service model, such as patient enrollment, care plan development, clinical outreach, medication reconciliation, health education, documentation, and care coordination with providers.

The best partners are like an extension of the practice and not an outside sourcing company.

Core Services to Expect

A complete CCM partner can offer:

• Support for identification and enrollment of patient eligibility.
• Development and maintenance of comprehensive care planning.
• Scheduled patient outreach
• Medication and treatment plan support.
• Care coordination with doctors/specialists
• The effective patient education and support for self-management.
• The documentation of activities of CCM is in progress.
• Increasing to clinical staff for concern with patient issues

The actual scope of the work will depend on the vendor, and practices should check what services the vendor is doing, and what services are still to be handled by the clinical organization.

Why do practices collaborate with CCM Companies?

Maintaining a successful CCM program within-house may be difficult. Staff are expected to consistently identify children for whom they are suitable, engage in meaningful interactions, record activities, review and update care plans, and arrange follow up, as well as undertake their normal clinical duties.

These workflows can be supported by dedicated resources from an external partner of the CCM community. This can enable physicians and other internal parties to concentrate on clinical decision making and training care management staff to manage and engage patients appropriately.

Reducing Administrative Pressure

CCM creates ongoing administrative tasks that are onerous and challenging to maintain given current staffing. Delegating some of these tasks may be an option for practices to utilize specific resources without the need to create an entire department.

Supporting the patient between visits

Most of the time spent outside the doctor’s office is by patients with chronic conditions. Many things can happen to their blood pressure, medication adherence, symptoms, diet, activity, or their ability to follow a treatment plan between visits.

How to Evaluate Chronic Care Management Companies

When choosing a partner for CCM, you’ll need to look at more than monthly rates. Practices should consider whether they can achieve clinically meaningful interactions in a way that fits into the organization’s care model.

Clinical and Staffing Expertise

Inquire about who really communicates with patients and the requirements they possess. Assess the company’s training policies for staff, supervision of patient interactions, and its approach to scenarios that need to be escalated to the provider.

A credible partner should also provide details on how it ensures continuity. When outreach is a part of patients’ healthcare relationships and not a disjointed string of calls from strangers, they are more likely to participate.

EHR Integration and Technology

Technology should not be a new silo, it should make CCM more easy to use. Review vendor integration with practice’s EHR and the flow of information between the CCM platform and clinical record.

Important questions include:

• What information can be shared with patients?
• What methods are used to record care plans?
• Are providers able to see completed activities?
• What is the method used to communicate tasks and escalations?
• How is information about patients kept safe?
• Will the platform scale with the number of users?

Integration should be evidenced in the assessment process as far as possible. A shiny sales presentation isn’t the sign of a workflow that will operate like a well-oiled machine during a hectic clinical day.

Documentation and Compliance Support

A vital component of CCM is documentation. CMS has requirements with respect to CCM services ranging from patient eligibility, consent, care planning, access to care, and time requirements for certain services.

Structured workflows and reliable records should make compliant documentation easier and easier for a vendor. But practices are still on the hook for a full grasp of Medicare, coding, documentation and compliance rules and regulations.

How is a CCM Partner Different from other Centers?

It is easy to think that the difference stems from one product versus another and actually forget about this when looking at vendors. A call center can offer Outbound calls, but chronic care management goes beyond just calling the patient and making a note that they spoke.

Patient communication and the patient’s care plan and clinical needs should be linked to a specialized CCM organization. For instance, when a patient says they are unable to take a prescribed medicine, it should set off a workflow, but not just be logged as a closed call.

Review Clinical Escalation Workflows

One of the most important skills to evaluate when choosing a vendor is effective escalation. One patient may need urgent attention for the reporting of worsening symptoms.

Ask vendors to know

1. The issue is documented by the care-management staff member.
2. The Escalation goes to the appropriate clinician or practice team.
3. The appropriate response is decided by the care team.
4. This is documented and a part of continuing care.
5. This is a much better indicator of the maturity of the vendor’s operation than a list of software capabilities.

Evaluating the effectiveness of a CCM Partnership

More than just the number of people enrolled in a CCM program should be used to assess a program. If the practice cannot determine if workflows are enhancing the care received by patients or if they are not enrolling patients, then there is little value in high enrollment.

Some performance indicators that can be useful:

• The recruitment and retention of patients.
• Successful outreach rates
• Completed care-management interactions
• Ensuring that care plans are completed and updated.Completing and updating care plans.
• Volume and resolution of escalation.
• Patient engagement
• Staff productivity

An advanced level thought is to check workflow friction which can be avoided. The program may be costly even if patient engagement looks good if care coordinators waste a lot of time looking to find information across systems, manually entering the same information, or figuring out who is responsible for a task. As enrollment increases, a good CCM partner should diminish those friction points.

Why Tellihealth is a Good CCM Partner

Tellihealth offers a more comprehensive strategy to chronic care, blending technology with care-management support. The CCM offering, signalCCM, aims to provide a solution for patient engagement and care coordination, documentation and workflows for healthcare organizations, and integration with current healthcare systems.

Conclusion

The optimal chronic care management firms have a mix of medical experience, dependable technology, and people skills. Patient engagement, adherence to documentation requirements, and workflows that seamlessly integrate with a practice’s operations.

Tellihealth is an excellent option for companies looking for a full-service CCM solution provider as it integrates care-management technology with committed care-management support, which can be integrated into larger remote care initiatives.

FAQs

Who should be involved in a CCM company?

There are several advantages for primary and specialty practice collaboration with a CCM company, as well as with hospitals and health systems. These services are particularly helpful to organizations seeking to increase their chronic care programs without burdening current staff with administrative and operational responsibilities.

How do I choose the right chronic care management company?

Assess the companies around the corner of clinical staffing, EHR integration, patient engagement, documentation processes, escalation workflows, reporting, scalability and the implementation support. It can also be helpful to ask to observe the vendor in a real patient-care situation.

Do Medicare companies need support from CCM companies?

There are a number of CCM companies that offer workflows and documentation tools to meet Medicare CCM requirements. Healthcare providers, however, are still required to adhere to applicable CMS eligibility, consent, documentation, coding and billing requirements.

 

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