Is It Time for New Revenue Streams?

webinar

Is It Time for New Revenue Streams?Presented by Rochelle Glassman June 23, 2016

@GoKareo

Agenda

2

Agenda

2

• Welcome & Introductions• Is It Time to Add New Revenue

Streams?• How Can Kareo Help?• Your Questions

@GoKareo 33

How to Participate Today…

Type your questions

Download today’s resources

View today’s presentation

@GoKareo 44

Connect via Social

Connect with us via social media

How to connect:

1) Follow @GoKareo on Twitter2) Follow @LeaChatham on Twitter

twitter.com@GoKareo

facebook.com/GoKareo

linkedin.com/company/kareo

https://twitter.com/GoKareo

https://www.facebook.com/GoKareo


http://www.linkedin.com/company/kareo




@GoKareo 55

Speakers

Rochelle Glassman

President, United Physician Services Nationally-recognized healthcare consultant Former executive-level consultant for Cigna Healthcare business entrepreneur 30 years of healthcare business experience President/CEO United Physician Services, LLC Physician Advocate Trauma-trained RN

@GoKareo

Agenda

6

Agenda

6



@GoKareo 77

You Can Make More Money

There are new opportunities: Many preventative services are now

covered!

Environment is changing from fee-for-

service to pay-for-performance.

New advances in medicine can be

added to your practice.

@GoKareo 88

Pay-for-Performance

Payment is based on metrics

HEDIS (Healthcare Effectiveness Data

& Information Set) Used by 90% of health plans

Quality measurements

Focuses on preventative care

More ‘whole picture’ approach

@GoKareo 99

Accountable Care Organization (ACO) Quality Measures

Patient / Caregiver Experience

Care Coordination Patient Safety

Preventative Health

At-Risk Population Diabetes

At-Risk Population Hypertension

At-Risk Population – Ischemic Vascular Disease

(IVD)

At-Risk Population – Heart Failure (HF)

At-Risk Population – Coronary Artery Disease (CAD)

There are 33 Quality Measures encompassing the following categories:

@GoKareo 1010

Merit Based Payment System (MIPS)

Program Performance Year

Medicare Part B Payment

Adjustment Year

Maximum -% Medicare Part B

Payment Adjustment

Maximum +% Medicare Part B

Payment Adjustment

PQRS/VBM 2016 2018 -4% penalty +4%*X incentive

MIPS 2017 2019 -4% penalty +4%*X incentive




Financial Impact

@GoKareo 1111

Screening for Diabetic Retinopathy (currently a HEDIS requirement)

Leading cause of blindness among

diabetics: Somewhere in the world, someone goes blind

every 5 seconds

415 million worldwide have diabetes

86 million have pre-diabetes

28.5% of diabetic patients have diabetic

retinopathy

According to UHC 80% non compliance rate

With early detection, 90% of vision loss can be

prevented.

@GoKareo 1212

Screening for Diabetic Retinopathy

In-house optometrist Increase patient compliance

Improve clinical outcomes

Reimbursement for eye exams AND bonus

from health plan! 92002 $81.63 (Exam; intermediate, New pt)

92004 - $149.66 (Exam; comprehensive, New pt)

92012 - $85.93(Exam; intermediate, Est pt)

92014 - $124.60 (Exam; comprehensive, Est pt) HEDIS Bonus: Based on compliance target met

@GoKareo 1313

Dermatology Care

Most common form of cancer,

but easily treatable

1 in 5 get skin cancer

Bringing in on-site dermatologist Additional revenue

Better detection

Improved compliance

@GoKareo 1414

Urine Drug Testing

Traditionally patients were sent to

the lab

Toxicology down to the nanogram

Better to assess in clinical setting

EHR compatible

Cost of cups, $55 - $75

Reimbursement $150 – $1,650- Medicaid & Medicare CPT (G0477)- Insurance & Work-Comp CPT (80300)

@GoKareo 1515

Drug Testing

Pain Management

Neurology

Anesthesiology

Surgeons (post operative and pre

operative)

Treatment centers

OB/GYN

Internal Medicine

Family Practice

@GoKareo 1616

Depression Research Results

New, clinically valuable

testing strategies

Target depression and

appropriate treatment

Screening for Depression

in Adults & Children

(99420, G0444) $18.26

ICD-10 Dx Z13.89

@GoKareo 1717

Depression Research Results

Primary care doctors misdiagnose depression 53% of the time

First of class blood test Looks at 9 bio markers across 4

pathways Score of 1-9 with sensitivity of 94% and

specificity of 92% overall accuracy of 93%

Score of 1-4 = 95% likelihood of not having major depressive disorder (MDD)

Score of 5-9 = 90% likelihood of having MDD

@GoKareo 1818

Pharmacogenetic Testing

100,000+ die each year due to

medication-related errors

770,00+ are hospitalized yearly for

Adverse Drug Reactions

Prescribe medications through science,

not guesswork!

Zero capital costs to the practice

@GoKareo 1919


New system of prescribing

according to genetic make-up More accurate

Better results

Less side effects

Potential marketing

Additional revenue stream

@GoKareo 2020


Remuneration of either $15 or $75

per patient working

Simple 30 second cheek swab

Reimbursed by all plans except

Medicaid

Specialties: primary care, internal

medicine, pain management,

neurology and psychiatry

@GoKareo 2121

Medical Weight Loss

Covered for up to 26 visits per year

(exclusions may apply) for patients

with a BMI >30. 1 visit every week for first month

1 visit every other week for 2-6 months

1 visit every month for months 7-17

CPT code G0447 (15 minutes)

@GoKareo 2222

Medical Weight Loss

Nutritional counseling covered with certain patients with diabetes and renal disease (i.e., CPT code 97802 and 97803)

Partner with specialties to attract patients

Great preventative measure to achieve benchmarks

Happier patients

@GoKareo 2323

Medical Weight Loss

Revenue for your practice B-12 Shots

Appetite Suppressants

Supplements

EKG for patients over 40 (CPT 93000,

12 lead with interpretation).

Reimbursement is $17.19*

(Recommended for patients taking

appetite suppressants over 45).

* 2016 CMS Fee Schedule - National

@GoKareo 2424

Allergy Program

More than 50 million people in the US have allergies.

If you test 8 patients per week for 60 spots (95004), average cost to practice is $28 with a total annual income of $75,400

Spirometry , expiratory flow rate measurement (94010) $36.52

Additional for quarterly visits for E/M code 99213 ($73.40) total of $220.20, per patient per year

Sub Lingual Drops Starter Set cost is $60 - $90 for a total annual revenue of $323 per patient per year

Maintenance Drops $150 - $180

@GoKareo 2525

Smoking Cessation

16.8 percent (40 million) of US adults smoke tobacco

Medicare Part B covers two levels of tobacco cessation per 12 month period

Private / Commercial insurers are required to provide evidence-based

@GoKareo 2626

Smoking Cessation

Symptomatic Patients 99406 (3-10 minutes intermediate counseling) CMS rate: $14.32

99407 ( > 10 minutes intensive counseling) CMS rate: $27.93

Asymptomatic Patients G0436 (3-10 minutes intermediate counseling) CMS rate: $14.68

G0437 ( > 10 minutes intensive counseling) CMS rate: $27.93

Note: 2 diagnoses are needed to support these code sets.

a. Tobacco counseling (Z71.6)

b. Nicotine dependence (F17.2--)

@GoKareo

Agenda

27

Agenda

27



@GoKareo 2828

Awards and Rankings

Growth awards The speed at which

medical practices are moving to Kareo and referring it to other

providers.

Best places to work Happy, engaged

employees stay longer, have more experience and

offer better customer service

Analyst reviews 3rd party recognition,

driven by direct customer feedback,

equals trust and credibility

@GoKareo 2929

Kareo Platform

Kareo Billing

• Centralized A/R Management

• Intuitive Billing Analytics • Easy & accurate charge

capture• ICD-10 Ready• Smarter billing/patient

collections• Secure messaging• Powerful scheduler/appt.

reminders

@GoKareo 3030

Kareo Platform

Kareo Clinical

• Comprehensive dashboard

• Simple charting• Easy ePrescribing• Convenient eLabs• Specialty templates• Electronic Superbill• Integrated Patient

Portal • Secure messaging

@GoKareo 3131

Kareo Platform

Kareo Managed Billing• Dedicated team of specialists • Simple scheduling/calendar• Charge Capture (web/mobile)• Nationwide Billing Rules Engine• Claims tracking• Billing Tasks• Billing Analytics

@GoKareo 3232

Kareo Platform

Kareo Marketing• Marketing and front

office automation• Online visibility and SEO • Online appt. scheduling • Email, text & voice

recording appt. reminders

• Post visit patient reviews• Practice analytics for ROI• Patient communications

@GoKareo 3333

Kareo and Chiron Health Make the Perfect Pair

Seamless Scheduling Integration

Automatic Insurance Exchange and Telemedicine Eligibility Verification

HIPAA- Compliant Video Visits

@GoKareo 3434

Discover Kareo’s Role

• PAHCOM has approved 1 CEU credit.• Each attendee will receive an email today

with a link to request certification. Certificates will be mailed within the next few days.

• Attendees must be logged into the webinar to receive credit.

• You’ll be asked at the end of the webinar if you want a CEU certificate.

“…Make Your Practice a Best Practice!”

@GoKareo

Agenda

35

Agenda

35



@GoKareo 3636

How to Participate Today…

Type your questions

-- Questions After the Webinar --

888.775.2736 [email protected]

mailto:[email protected]

Connect with KareoStop by and say hi!

Kareo @GoKareo GoKareo Kareo

3353 Michelson Drive, Suite 400Irvine, CA 92612(888) 775-2736

https://www.linkedin.com/company/kareo

https://twitter.com/GoKareo


https://plus.google.com/u/0/+KareoOfficial/posts

Is It Time for New Revenue Streams?

Healthcare

Transcript of Is It Time for New Revenue Streams?