What is PharmD Live’s Service Offering?
PharmD Live’s clinical pharmacists have an answer to improving patient satisfaction, reducing the stress of proper documentation, with the advantage of their advanced training and knowledge of pharmacology. With PharmD Live on your team, drug-drug interactions, therapeutic interchanges, and informatics, we provide patients who have complex medical conditions the best health outcome possible based on Medicare’s Chronic Care Management program.
Implementing an efficient Chronic Care Management program will mean achieving high-quality measures in patient care experience, care coordination, patient safety, and preventive health. Achieving these measures will yield significant population health revenue for your practice. The amounts reimbursed by Medicare will depend on the number of patients enrolled in the CCM program and your ability to reach specific thresholds. Reimbursement amounts by Medicare can become quite lucrative, with providers earning upwards of $100,000 in additional revenue.
One caveat for consideration: a lot of administrative time needs to go into preparing the Medicare documentation which is why partnering with PharmD Live for Chronic Care Management services is highly recommended. We enroll and develop monitoring relationships with your patients, take care of documentation, recording in EHRs, and make detailed CCM billing seamless for office staff.
Which Healthcare Settings Does PharmD Live CCM Serve?
CCM is often associated with healthcare providers in primary care, internal medicine, and family practice. PharmD Live’s chronic care management solution is scalable and customizable from smaller medical practices to larger health organizations, including:
- Hospitals and Health Systems
- Accountable Care Organizations
- Integrated Delivery Networks
- Healthcare Payors
How Does PharmD Live CCM Benefit the Medical Practice?
Our chronic care management solution primarily provides better care and health outcomes to the patients who enroll in the service. CCM directly affects patient engagement, satisfaction, and loyalty, and has demonstrated benefits in numerous areas.
- Reinforce the physicians plan of care to the patients
- 24/7 access to a PharmD Live clinical pharmacist for questions
- Up-to-date and correct medication list in the EHR
- Improved medication adherence based on a direct patient relationship
- Actionable clinical intelligence
- Reduced ER visits and hospitalizations
- Personalized care plan for progress toward health goals
- Lower healthcare costs
- Improved care coordination between and among all healthcare providers and settings
How Does CCM Generate Revenue for Providers?
Also important to the medical provider is the revenue stream that PharmD Live’s CCM services will generate. Before the Chronic Care Management program, care management outside an office visit was not always billable. With CCM, the medical practice now has a source of revenue for services that are likely already provided, such as answering phone calls and scheduling referral appointments. PharmD Live’s chronic care management solution takes up those responsibilities, adds expert pharmacological oversight, and automatically creates a monthly billing report for the practice to submit to CMS for reimbursement. Depending on the number of patients enrolled, the additional monthly revenue from CCM activities can reach $5,000-$10,000 or more per healthcare provider.
Can PharmD Live Reduce Provider Workload for CCM?
PharmD Live Chronic Care Management helps relieve the workload of the healthcare provider and clinical team members, such as nurses, medical assistants, and office staff. When patients enroll in CCM, they have 24/7 access to the PharmD Live clinical pharmacist to answer questions, schedule appointments, and coordinate care. With personalized care coordination of their chronic conditions, patients are less likely to need urgent appointments, ER visits, or hospitalization. Reduce the need for urgent intervention and relieve the practice’s unscheduled workload. PharmD Live CCM eases the stress of handling day-to-day interactions with patients’ whose complex conditions, that until now, took up provider and staff time without compensation.
Does PharmD Live CCM Affect Medicare Reimbursement?
Chronic Care Management is designed specifically to influence patient health and intervene before health issues worsen. CMS says outcome measures “show how a health care service or intervention influences the health status of patients.” PharmD Live solutions make it easier for providers to select and report the most significant and useful data to maximize adjustment to the Medicare physician fee schedule.
Care providers now operate under the Quality Payment Program (QPP) with two tracks. Both emphasize value-based payment models:
- MIPS (Merit-based Incentive Payment System) for most practitioners, and
- APM (Alternative Payment Model) for certain uncustomary practice types.
PharmD Live helps your practice maximize the quality measures you track. The Chronic Care Management measures under MIPS:
- Tie Medicare payments to quality and cost-efficient care,
- drive improvement in care processes and health outcomes,
- increase the use of healthcare information, and
- reduce the cost of care.
PharmD Live has strategies and proprietary software to maximize 88 performance measures in four areas:
- 55 Quality measures
- 27 Improvement Activities measures
- 5 Promoting Interoperability
- 1 Cost measure
References
- https://www.cdc.gov/chronicdisease/about/index.htm
- https://www.cms.gov/About-CMS/Agency-Information/OMH/equity-initiatives/ccm/hcpresources
- https://www2.ccwdata.org/web/guest/home/
- https://www2.ccwdata.org/web/guest/condition-categories
- Boersma P, Black LI, Ward BW. Prevalence of Multiple Chronic Conditions Among US Adults, 2018. Prev Chronic Dis 2020;17:200130. DOI: http://dx.doi.org/10.5888/pcd17.200130
- https://www.cms.gov/About-CMS/Agency-Information/OMH/Downloads/connected-hcptoolkit.pdf
- Buttorff C, Ruder T, Bauman M. Multiple Chronic Conditions in the United States
[PDF – 392 KB]. Santa Monica, CA: Rand Corp.; 2017.
- Martin AB, Hartman M, Lassman D, Catlin A. National Health Care Spending In 2019: Steady Growth For The Fourth Consecutive Year. Health Aff. 2020;40(1):1-11.
- https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/chroniccaremanagement.pdf
- https://www.cms.gov/About-CMS/Agency-Information/OMH/equity-initiatives/ccm/hcpresources#resources-for-you
- https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/Value-Based-Programs/Value-Based-Programs