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Medicare Reimbursement is Broken

Posted by: Andrew Mills Comments: 0

Providers and practice managers are frustrated with the current Medicare reimbursement model for chronic conditional care—and the chronic care management programs not working well for many of their Medicare patients.  For instance, we can all relate to a parent or grandparent who forgets to take his medicines…or an elderly friend who waited two months for her next doctor’s appointment to address a condition actually needing immediate attention.   

It is obvious the system is broken because, services like remote patient monitoring and chronic care management are significantly underutilized – less than ~10% penetration rates. The low reimbursement rates coupled with the workload has led many practices to consider dropping Medicare.  Some of my friends who are physicians have told me themselves that these services either don’t provide the promised value or require too much additional workload on them and their staff.  

Articles similar to this one from the Washington Post are appearing consistently:  

(https://www.washingtonpost.com/business/2020/09/08/family-doctors-financial-crisis-coronavirus/?arc404=true).

Many Medicare patients need additional support and struggle to follow their care plans, so they require much more time than the practices can efficiently provide within the reimbursement framework. As a result, many practices prioritize the focus on the most critically ill patients.

Physicians are also frustrated with the lack of time they have available to manage the rest of the pool of chronically ill patients who may be silently suffering but haven’t come into the office or have been admitted to the ER or hospital. Most of the issues happen outside of the office. It is hard to manage what you can’t see.

The underlying problem is that EHRs were not designed to support continuous care outside of the office. Without an automated system or cumbersome workflows, practices cannot continuously manage all of their elderly chronic patients in-between appointments as the process is too manual, time-consuming, resource-intensive, and expensive.

CareTrack has a better solution to help your practice to:

  • Empower physicians, staff, and care team members to work from the same customized playbook to continuously support their well-being in-between office visits.
  • Enable physicians with latest patient information updates at their fingertips to assess patient progress, and real-time health changes, which includes an early warning system to proactively catch potential issues early to reduce ER visits and hospitalizations, close patient’s adherence gaps, and improve clinical outcomes.
  • Extend the practices’ ability to support elderly patients who have multiple chronic conditions without increasing the workload and improve your quality scores to change the economics for the practice.
  • Enhance practice revenue by capturing all Medicare billing codes for appropriately managing your Medicare and Medicare Advantage patients outside of the office.

All of this with no additional capital outlay or new system to learn.  Click here to learn more about how CareTrack’s telecare solution can help you better care for your Medicare patients while enhancing your bottom-line revenues.

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