Top 5 videos from HIMSS17

Top 5 videos from HIMSS17

Chronic care management tools forge bridge to value-based care

CCM technology can help providers set the stage for other forms of value-based reimbursement that are coming.
By John Andrews
08:06 AM

As the healthcare industry shifts away from fee-for-service to the value-based payment model, hospitals will need better tools to manage services throughout the continuum of care.

“We’ve all been waiting for the moment when providers are reimbursed for keeping patients healthy and it arrived this year,” said David Rowe, senior vice president at Kryptiq. “Chronic Care Management (CCM) payments from CMS represent the bridge to value-based reimbursement because it’s an incentive with no downside risk to monitor the Medicare patient’s health. If you deploy the technology in the workflow to pursue CCM, you’ve set the stage to pursue other forms of value-based reimbursement that are coming.”

The CCM program went into effect on Jan. 1 and reimburses physicians approximately $40 per month for providing 20 minutes of non-face-to-face patient management of chronic illness.

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And at HIMSS15 Kryptiq will demonstrate a suite of products that can align resources with care plans and provide clinicians and financial teams with data along various points of care.

Specifically, Kryptiq’s Central Worklist generates a task list for the care team and that stream of tasks will enable clinicians to perform duties necessary to capture the CCM reimbursement, Rowe said.

“It builds the task list and distributes to the care team for many use cases, including Medicare Shared Savings Program,” he explained. “Electronic health records are not geared for longitudinal care over time, so this tool compliments EHRs with a longitudinal care plan.”

In addition to Central Worklist, Kryptiq will demonstrate its CareManager Analytics and the CareManager 4.5.

CareManager Analytics is a business intelligence tool built for population management, designed to identify priority cohorts and predict the economic value of early intervention. It builds and stratifies the patient registry and pushes it to the clinician level. The data model it builds helps providers select the appropriate intervention.

CareManager 4.5 is Kryptiq’s first iteration of the care coordination tool developed at Providence Health & Services. It is “a refactoring of the original Providence code-base,” Rowe said, “featuring more than a dozen new chronic disease states added to the library, packaged in a new user interface.”