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Increasing Profits with Medicare

Posted by: Andrew Mills Comments: 0

Recently, a primary care physician confided in me about issues within his practice. He stated that before implementing CareTrack, the “business” of Medicare was negatively impacting patient care. Physicians and staff were feeling utterly overwhelmed, limited by in-office time and declining reimbursements. As a result, the practice considered dropping Medicare, becoming a concierge practice, or joining an ACO.

With CareTrack, the practice is showing improvements. More Medicare patients began receiving additional needed services, and the clinical staff is comfortable with the added care. CareTrack’s Telecare practice extension provides continuous monitoring and coordination of out-of-office care for Medicare patients between appointments. CareTrack’s Telecare takes advantage of Medicare reimbursable services. It helps practices promote and expand utilization to larger Medicare patient populations, elevating quality metrics from 200% to 600% and increasing profitability by nearly $190,000 per physician in 2020.

Additionally, CareTrack’s Telecare offloads the time-consuming and mundane tasks so that in-office visits are focused on patient care and tasks required of an in-person visit.  

As it turns out, the time crunch was not limited to this practice and comes up in almost every conversation I have with primary care clinicians. In fact, researchers at Duke University have published several studies that illustrate that the lack of physician time is a significant contributor to shortfalls in delivering prescribed health care services. For example, according to national health care standards for preventive services and chronic disease management, it takes 21.7 hours per day to adequately meet the needs of a typical patient panel of 2,500, including the time required for acute problems. Of course, I feel like this physician is superhuman (like most physicians I know), but 21.7 hours a day is untenable.

In addition, most Medicare patients require a significant amount of added support because 80% of Medicare patients have a chronic illness. As patients age and the severity of illnesses increases, so does their struggle to follow care plans. These patients require more time than a practice can efficiently provide within the reimbursement framework of in-office care and follow-up via phone. By necessity, practice staff spends more effort with urgent health issues rather than long-term health concerns, which prevents primary care clinicians from delivering the recommended care. As a result, this doctor’s practice prioritized the most critically ill Medicare patients before their chronic but stable Medicare patients. 

Low utilization is a symptom of a broken model. Medicare designed programs to allow primary care practices to help the large population of Medicare patients with chronic diseases. However, the programs go underutilized, with some less than 10% utilization rates. Moreover, without an automated system and cumbersome workflows, practices cannot continuously manage their chronic Medicare patients between appointments. It requires a significant amount of time, manual input, resources, and expense. The result is that patients struggle and physicians stress, while Medicare needs to reduce avoidable medical expenditures.

CareTrack’s Telecare is the solution. The physician told me that CareTrack relieves many mundane and time-consuming tasks that staff previously performed for free. The solution extends the care team while he and his staff began optimizing their facetime with all patients. As a result, he can bill for more than only in-clinic time and eliminate most of the administrative time that his staff was doing for free. Most importantly, the solution increased the impact on his chronic patients’ health.

CareTrack’s Telecare is a remote-based care coordination program that manages patients in between appointments. The program supports practices’ current telehealth program and care coordination for critical and chronic but stable Medicare patients. Implementing a Telecare program for all Medicare patients can significantly improve care delivery, including the additional resources to help decrease physicians’ workload, substantially increase Medicare reimbursement, and save time and effort.

CareTrack’s solution helps empower staff members, update physicians with current patient information, extend practices’ ability to support elderly patients, and enhance practice revenue. The benefits of implementing the program go beyond that. CareTrack helps you provide Telecare to all patients while giving them the best care and benefiting the entire practice.

For more information on why you should adopt Telecare, please read CareTrack’s 40 Reasons Why You Need a Telecare Program in 2021.

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