Bob and Mary are long-time Medicare patients and have been with the practice for years. You know about their children and grandchildren. They are now mid-70’s retirees whose health is starting to decline. Bob has faced significant health issues for years and has been in and out of the hospital. Your team is intensively involved with Bob’s condition both in and out of the office. Mary attends every appointment as Bob’s caregiver.
In contrast, Mary has faced several chronic conditions but has been stable for several years and hasn’t had any ER visits. Mary is on a regular appointment schedule, but she isn’t a candidate for an intensive care team follow-up like Bob. You still see her regularly at Bob’s frequent appointments but do not check in on her health.
In reality, you aren’t aware of Mary’s health status since her last appointment because she is considered “chronic but stable.”
Given the stress of caring for Bob, her conditions, and her age, many practices consider Mary a candidate for a less intensive care program to manage her health between appointments (if offered by the practice).
Most practices don’t allow a moderate intensity program for chronic but stable patients such as Mary. Critical patients like Bob take up a large percentage of an internal care team’s focus.
The high-intensity care team follows the most critical patients, and the chronic but stable patients are cared for with the standard appointment model. This creates a gap in the system for chronic but stable patients who need more at-home tools to support and detect health problems between appointments.
It’s a matter of when, not if, a chronic but stable patient will experience an acute exacerbation. Nationally, patient non-adherence makes up 1/3 of Medicare patient ER visits.
CareTrack extends the practices’ out of office care between appointments to deliver exceptional care to ALL Medicare patients, whether critical or chronic but stable. CareTrack’s Telecare provides a system with more out-of-office support beyond the appointments (including telehealth) and less intensive/costly than the internal care team model.
Learn how CareTrack can ensure proper care of both Medicare patients, your Bob and your Mary.
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