CMS won't pay for telephone, email care services -- but they can still make you money

by Roy Edroso on Mar 29, 2017

The April 3 issue of  Part B News includes an article on getting value out of online and telephone codes Medicare won't pay for. One of our sources, Betsy Weaver, co-founder, CEO and president of UbiCare, a patient engagement solutions company in Boston, had some extra thoughts on how you can use online and telephone encounters to offer a care advantage that can also lead to increased reimbursement:

What we’re talking about is leveraging digital access – like email and SMS (texts) to patients in our clients’ practices to help them become more efficient – reducing time, effort and cost – while improving patient access to care.

In this new era of value-based health care, there are care encounters -- but, because of CMS regulations [such as episodic payment models], there are also entire care episodes in which practices have a role to play. Hospitals have to connect effectively with patients in a care episode before, during and post-discharge or they’ll be ‘dinged’ financially.

Medicare has set up free annual wellness visits [and Welcome to Medicare visits] for its beneficiaries… Medicare reimburses providers and there’s no cost to patients. But you have to reach those patients to let them know that these free visits exist.

[As many as] 72% of patients are looking online for health information. They bring back all this scary and wrong information they get from Dr. Google… You want the health care practice to answer their questions.

Our solution – and solutions like it – lets the practice connect with patients automatically once they are enrolled…Say I tell you, “It’s time to replace that knee, how do you want to stay in touch?” You say email and text. The doctor can then guide and follow the patient through the care episode. Maybe later you’re wondering how soon after the operation you could expect to return to your normal activities. You get a message from your provider following up on your knee surgery that not only answers that question but also links you to further resources about your recovery and lets you contact your practice. The technology shares content that will proactively answer patients’ questions. But patients and providers can interact to continue the conversation as needed [via an “Ask me/Tell me” feature].

We all want the most personalized care for the least amount of time and effort -- and there’s a cost associated with that. The cost runs both ways. If you connect with your patients proactively and you regularly sustain that connection, it is personalizing their medical care one episode at a time. It’s also reducing your time and effort, which is ultimately a cost savings.

Bottom line: It’s not surprising that two-way digital connections are quickly becoming the norm. They are a win-win-win – for patients, practices and health care.

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