Many healthcare organizations are seeking to hire chronic care staff with the rise of remote care. However, managing a chronic care staff can be tricky when it comes to operating a medical practice. At times the chronic care staff can be pulled away from their current work when there is an office shortage making it difficult at times to have staff dedicated to remote chronic care. Many healthcare staff are looking for work from home jobs as well. However, having staff working remotely has its challenges including managing productivity and long-term viability.
Since members of the medical practice are very busy during the day at the office it may not always be easy to monitor clinical healthcare staffing’s productivity unless you put a method or software in place to do so. Additionally, when chronic care staff provide services that can be billed to payers like Medicare you will need to have a nurse or provider audit their work to make sure it is in compliance with Medicare standards for scope of service before billing services. At times it may be easier to outsource chronic care staffing to a trusted chronic care management company.
What is Chronic Care Staffing?
Chronic care staffing is the staffing of a clinical team to help manage, monitor and coordinate care for patients with chronic conditions. Staff can be based in an office as well as the staff can work remotely. A chronic condition is expected to last at least one year or until the death of the patient. A chronic condition places the patient at risk of functional decline, acute exacerbation/ decompensation or significant risk of death.
CMS provided an exception under Medicare’s “incident to” rules that permits clinical staff to provide the Chronic Care Management (CCM) service incident to the services of the billing physician (or other appropriate practitioner) under the general supervision (rather than direct supervision) of a physician (or other appropriate practitioner). Due to clinical staff being able to work under the billable provider’s general supervision, this has led to a rise in chronic care staffing that is only exacerbated by the increased need for managing, monitoring and coordinating care for patients with chronic conditions.
Adapting to the Chronic Care Staffing Crisis with Remote Care for CCM
As we have seen from the pandemic, there is a shortage of clinical staff to support providers. Thankfully due to the enhancements to provide remote care this helps alleviate some of the care staffing crisis. Chronic care management can now provide chronic care services across the country even in rural and underserved areas. Remote care can be provided telephonic, through messaging and/or through remote monitoring. Hiring a chronic care staffing organization to provide remote care for patients allows care to be more timely and provides services to chronically ill patients at home or anywhere at any time. Many patients enjoy receiving ccm services from the comfort of their home since they do not have to worry about arranging transportation, spending extra time and incurring extra costs of gas that are needed for an in person office visit. Research studies have demonstrated time and time again that chronic care management reduces the total cost of care for chronic disease patients while improving their overall health.
The Benefits of Outsourcing Chronic Care Staffing for your Practice
There are many benefits to outsourcing chronic care management staffing. Outsourcing chronic care management staffing relieves the burden of hiring, managing and monitoring the chronic care staff since you are relying on a third party to manage this burden. Your practice can concentrate on spending your time and your staff’s time on patients coming into the office. Then, the chronic care staffing company will be responsible for the following:
- Implementation costs such as: computer, headset, and training
- Management of operational items such as: nurse auditor, recorded call lines used by care team, payroll costs of software
- Staffing chronic care personnel and hiring costs such as: job boards, background check, drug test, taxes and health insurance, additional nursing insurance, PTO and vacation time.
Examples of Chronic Conditions that Can Benefit from Care Management
Among the many any chronic conditions that we see benefit from care management services are diabetes, hypertension, chronic health failure (CHF), chronic obstructive pulmonary disorder (COPD) and Parkinsons. A robust list of chronic conditions can be found on CMS’ Chronic Condition Data Warehouse. This is not an all inclusive list since additional conditions can be considered chronic as long as they meet the definition of what is considered a chronic condition which was mentioned earlier.
A chronic condition is expected to last at least one year one year or until the death of the patient. A chronic condition places the patient at risk of functional decline, acute exacerbation/ decompensation or significant risk of death.
How to Help your Staff Identify Eligible Chronic Care Management Candidates
You can train your staff to identify eligible chronic condition patients for chronic care management by having them understand who qualifies for this type of healthcare. A qualifying chronic condition patient must meet the criteria which is they need to be diagnosed with a condition that is expected to last at least 12 months or until the patient dies. Additionally, the condition must place the patient at significant risk of death, acute exacerbation, decompensation or functional decline. Once this criteria is met the patient is eligible to receive chronic care management services.
The Benefits of CCM to your Patients
CareVitality’s Chronic Care Management (CCM) services allows you to take advantage of our robust CCM service solutions covering everything from creating comprehensive care plans, care management, care coordination, preventive services, reimbursement guidance and medication reconciliation while you focus on in office care and telemedicine visits.
Additional benefits to your patients are as follows;
- Providing support for patients to achieve their desired health goals
- Preventive services follow up such as: annual wellness exam, IPPE, diabetic eye exam, annual eye exam, colorectal screening, influenza vaccines, shingles vaccine, tetanus vaccines, mammogram and others.
- Assistance with scheduling preventative services
- Medication refill assistance
- Referral request assistance
- Mobility assistance (request for a walker, wheelchair, etc…)
- Transportation assistance
- Assistance with scheduling follow up PCP or specialist appointments
- Transitional Care Management and Urgent Care services (included now as part of the updated CCM services guidelines)
- Support in accessing diagnostic tests and lab results
- Creating and revising comprehensive care plans for each patient when needed
- Providing support for caregivers caring for the patient
- Assistance with Social Determinants of Health
Meet the CareVitality Chronic Care Staffing Team
Since 2016, CareVitality’s chronic care staffing team has been outsourcing Chronic Care Management, Annual Wellness Visits, Health Risk Assessments, and Transitional Care Management services. Since the expansion of telehealth we have expanded our services to add in General Care Management, Principal Care Management, Behavioral Health Integration, Remote Physiologic Monitoring, Remote Therapeutic Monitoring Services, Virtual Clinical Staff Augmentation, Medicare reimbursement and additional care management/ care coordination services.
We have a long term partnership with our clients and can develop additional programs that can help meet our clients needs. Our parent company has been doing EHR implementations, audits, HIPAA and cyber security consulting since 2009. This experience allows us to have successful implementations, trust that the patient data is handled securely, and provide exceptional patient care which leads to satisfied clients working with us year after year that meet compliance requirements when audited.
Since 2016, CareVitality’s clinical and legal team have developed industry leading and compliant documentation requirements, population health services and technologies along with value-based virtual care protocols to increase future reimbursement and improve patient outcomes before, in-between and after care encounters.
By taking a proactive and flexible approach to care staffing, healthcare organizations can effectively manage their staffing needs and provide high-quality care to patients. Thanks for writing on such an informative topic no one is talking about.