Physician Practices Begin Billing Medicare For Chronic Care Management Services

BEAVERTON, Ore., May 21, 2015 /PRNewswire/ -- Kryptiq, a market leader in population health management, today announced that innovative provider organizations have begun using Central Worklist, its cloud-based care team tasking engine, to bill Medicare for chronic care management (CCM) services. These clinics will be among the first to participate in the Centers for Medicare and Medicaid Services' (CMS) CCM program.  

CMS began allowing providers who actively manage care delivery for Medicare patients having two or more chronic conditions to bill for service using CPT code 99490 on January 1^st. Providers are required to use a certified EHR, obtain and manage patient consent, deliver five core care management services, and provide at least 20 minutes of follow-up outside of the office (i.e. non-face time care) in conjunction with the CCM program.

Chronic Care Management Programs Require Technology

The Center for Primary Care, a comprehensive healthcare clinic with 37 physicians spread across nine offices in Georgia and South Carolina and managing a panel of more than 127,000 patients, is tapping Central Worklist, including its integrated chronic care management program, to help capture beneficiary consent, coordinate care, as well as track and bill for CCM services. "The vast majority of our Medicare patients meet the eligibility criteria established by CMS," stated Barry Allison, Chief Information Officer at the Center for Primary Care. "While practice management vendors have been somewhat distracted by Meaningful Use and other regulatory requirements, Kryptiq has helped us rapidly implement a CCM program. Central Worklist allows us to consistently apply care management protocols, continuously informs the team of progress toward care plan objectives, and optimizes resource allocation. We anticipate that it will help us to capture nearly $2 million in incremental billings, which is significant as fee for service margins continue to come under pressure."

In addition to the Center for Primary Care, Wake Internal Medicine Consultants, Inc., a medical practice with 30 providers who deliver general medical and subspecialty care to adults and children in Raleigh, North Carolina, enlisted Kryptiq to help upgrade its chronic care management program. "We billed on our own, which was great, but we were concerned about scalability," said Vikki Jones, Clinical IT. "We are thrilled to collaborate with Kryptiq's implementation and development teams to leverage what we have learned so far, and accelerate the realization of CCM's full potential through Central Worklist."

"Many of our physician practice customers are already providing these types of services to their Medicare populations," observed Malcolm Costello, General Manager of Population Health at Kryptiq. "By codifying a CCM workflow and delivering it within a purpose-built software application, we are ensuring they meet CMS' billing requirements and capturing the revenue that might have otherwise been missed. In the process, we are also helping them leverage existing staff through enabling health IT, while providing the blueprint for the future expansion of their value-based initiatives."

Chronic Care Management Is a Bridge to Value-Based Care

The Department of Health and Human Services (HHS) recently announced that it has begun to accelerate the transformation of the healthcare delivery system by more aggressively employing new incentives to motivate higher quality care, increasingly tying value to payment through alternative channels, and supporting emerging care team models.

Initiatives like Medicare's chronic care management program were specifically designed to support this transformation and serve as a bridge to value-based care, according to Cynthia Burghard, Research Director at IDC Health Insights. "They provide the opportunity for providers to gain experience in value-based care, as well as the implementation and management of patient facing care management programs prior to more broadly deploying." Providers that invest in the required CCM technology and workflows will be well-positioned to pursue other programs, including bundled payment for care improvement (BPCI) and Medicare's shared savings program (MSSP). 

In an April webcast hosted by Healthcare IT News, nearly 80% of providers surveyed indicated they would initiate a CCM program within 12 months. For more information on Kryptiq's chronic care management program or population health management solutions, please visit Kryptiq.com.

About Kryptiq

Kryptiq develops solutions for population health and patient relationship management, enabling providers to identify care opportunities informed by clinical and financial data at the point of care. By unifying care teams and connecting provider organizations, we help healthcare delivery organizations improve patient care quality, practice efficiency, and accountability.

Resources

Kryptiq White Paper: Providing and Billing for Chronic Care Management
http://www.kryptiq.com/download-chronic-care-management-white-paper/

Healthcare IT News Webcast: A Practical Guide to Chronic Care Management
http://www.kryptiq.com/value-based-programs/

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SOURCE Kryptiq Corporation

Related Links

http://www.kryptiq.com