Healthcare Benchmarks and Metrics February 2015 · PDF fileHealthcare Benchmarks and Metrics...
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Healthcare Benchmarks and Metrics February 2015 www.hin.com The Healthcare Intelligence Network • 800 State Highway 71, Suite 2 • Sea Girt, NJ 08750 888-446-3530 • [email protected] Chronic Care Management in 2015: Nearly 1 in 2 Healthcare Organizations Poorly Positioned for Care Coordination Revenue
Transcript of Healthcare Benchmarks and Metrics February 2015 · PDF fileHealthcare Benchmarks and Metrics...
Healthcare Benchmarks and Metrics February 2015
www.hin.comThe Healthcare Intelligence Network • 800 State Highway 71, Suite 2 • Sea Girt, NJ 08750
888-446-3530 • [email protected]
Chronic Care Management in 2015:
Nearly 1 in 2 Healthcare Organizations Poorly Positioned for Care Coordination Revenue
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February 2015 • Chronic Care Management in 2015
Chronic Care Management in 2015: Nearly 1 in 2 Healthcare Organizations Poorly
Positioned for Care Coordination Revenue Despite new CMS payments to physician practices for select chronic care management (CCM) services, almost half of healthcare organizations lack a formal chronic care management program, leaving critical reimbursement dollars on the table, according to new market metrics from the Healthcare Intelligence Network (HIN).
Almost 45 percent of respondents to HIN’s 2015 Chronic Care Management survey have yet to launch a CCM initiative, the survey determined.
However, 92 percent of respondents believe the Medicare CCM reimbursement codes that became effective January 1, 2015 will prompt equivalent quality overtures from private payors, underscoring care coordination’s importance in a value-based healthcare system.
A diagnosis of diabetes is the leading criterion for admission to a chronic care management initiative, said 89 percent of respondents with existing CCM programs, closely followed by chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF), both identified by 81 percent.
Follow-up with patients immediately following hospital discharge is the most common component of CCM initiatives, said 81 percent of respondents.
Survey Highlights
�� A primary care physician or healthcare case manager most often bears primary responsibility for CCM, say 29 percent of survey respondents.
�� Just over one-third of respondents—35 percent—are currently reimbursed for activities related to CCM.
�� Patient engagement is the most difficult challenge of chronic care management, according to one-third of survey respondents.
Buy the Complete ReportNeed more data from this survey? The Healthcare Intelligence Network has produced 2015 Healthcare Benchmarks: Chronic Care Management, a 40-page resource capturing tools, practices and lessons learned by 119 healthcare companies related to the management of chronic disease.For more information on this report, please visit: http://store.hin.com/product.asp?itemid=5003
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February 2015 • Chronic Care Management in 2015
Program Components
�� The majority of chronic care management tasks are conducted telephonically, say 88 percent of respondents.
�� Almost three-quarters of respondents—72 percent—admit patients with hypertension to CCM programs, respondents said.
�� Healthcare claims are the most frequently mined source of risk-stratification data for CCM, say 72 percent of respondents.
�� More than half of respondents—51 percent—include palliative care or management of advanced illness in CCM programs.
�� On average, each CCM patient is seen monthly, say 29 percent of respondents.
8.3%
27.1%
29.2%
31.3%
52.1%
70.8%
87.5%
Other
E-visits
Patient portal
Securemessaging
Home visits
Face-to-face
Telephonically
0.0% 20.0% 40.0% 60.0% 80.0% 100.0%
How is Chronic Care Management conducted?
Related Blog Posts
Sizeable Opportunities in Chronic Care Management
Reimbursement: Healthcare
organizations don’t have much time to prepare
for newly released 2015 Medicare...
Chronic Disease Leading Cause of
Avoidable ER Visits
Chronic disease edged out pain management as the top complaint
among this population...
CCM Readiness Training:
Chronic Care Management Medicare Reimbursement: New
Revenue Opportunities
Chronic Care Management
Reimbursement Compliance
Chronic Care Management Delivery Methods
© 2015 HIN 10 Questions on Chronic Care Management, January, 2015
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February 2015 • Chronic Care Management in 2015
Results and ROI
�� Reimbursement for chronic care management is a challenge for 20 percent of respondents.
�� Seventy-seven percent say CCM programs have improved self-management levels in enrolled patients.
�� Almost half—46 percent—say CCM has decreased hospitalizations in the population served by the program.
Successful Work Flows, Processes and ToolsHere is a sampling of successful chronic care management strategies shared by survey respondents:
�� “Coaching the patient to wellness and holding them accountable.”�� “Any patient over a certain risk score gets a phone call from the physician or
advanced practice nurse to follow up with the patient.”�� “Improved communication between Guided Care nurse and MD.”�� “Patients can identify their care coordinator by name and know how to call for
support.”�� “A patient registry and population health management software.”
About the SurveyThe 2015 10 Questions On Chronic Care Management survey was administered in January 2015 via the Healthcare Intelligence Network Web site at http://www.hin.com. Respondents were invited to take the survey via e-mail, e-newsletter and social networking reminders throughout the month. A total of 119 healthcare companies responded to the survey, which asked 10 questions on chronic care management, with multiple responses possible on some questions. Some questions were open-ended, inviting write-in responses. Not all surveys were fully completed. Data is qualitative, and results were compiled by the Healthcare Intelligence Network.
Respondent Demographics
Responses to the January 2015 survey on chronic care management were submitted by 119 organizations. Of 75 respondents identifying their organization type, 27 percent were hospitals, 17 percent were physician practices, 10 percent were disease management or health coaching organizations, 11 percent were health plans, 8 percent were physician-hospital organizations (PHOs), and 23 percent categorized their organization type as ‘Other.’
Industry Experts Weigh In...
Medicare Chronic Care Management
Rick Hindmand, attorney with McDonald Hopkins
Humana Remote Monitoring Pilots Engage Members
Gail Miller, VP of telephonic clinical operations, Humana
Cares/SeniorBridge
Care Coordinators Boost Value-Based
Rewards
Chip Howard, Humana vice president of payment
innovation
More “Chronic Care Management” Health
Podcasts in Our Archive
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February 2015 • Chronic Care Management in 2015
Option 2: Save $500 Annually with Benchmarks MembershipWant instant digital access to new healthcare benchmarks the day they’re published — for a full year at a substantial discount? Then the HIN Healthcare Benchmarks membership is for you.
HIN Healthcare Benchmarks members are emailed a PDF of new healthcare market data the day it’s issued. (Choose the “Recommended” option for a same-day PDF and print copy on publication, at an additional 30 percent savings.)
The HIN Benchmarking series provides continuous qualitative data on industry trends to empower healthcare companies to assess strengths, weaknesses and opportunities to improve by comparing organizational performance to reported metrics.
For more details, please visit: http://store.hin.com/product.asp?itemid=4664
Or call HIN toll-free at 888-446-3530.
About the Healthcare Intelligence NetworkThe Healthcare Intelligence Network (HIN) curates high-quality information on the business of healthcare. Healthcare executives can receive exclusive, customized real-time news and data in their preferred format in five key areas: healthcare and managed care, hospital and health system management, health law and regulation, behavioral healthcare and long-term care.
Contact Us: Healthcare Intelligence Network800 State Highway 71 Sea Girt, NJ 08750Phone: (888) 446-3530 Fax: (732) 449-4463E-mail: [email protected]
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You might also like these informative HINfographics:
Parsing Palliative Care and the Patient Experience
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Option 1: Buy the Full ReportDownload the PDF instantly ($117) or order a print copy ($127) of 2015 Healthcare Benchmarks: Chronic Care Management for actionable metrics from 119 healthcare organizations on chronic care management. For more information on this report, please visit: http://store.hin.com/product.asp?itemid=5003
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