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2016 Updates to Chronic Care Management CPT Code 99490

2016 Updates to Chronic Care Management CPT Code 99490

FQHCs and RHCs Are Now Able to Bill for CCM Services When CMS introduced the opportunity for providers to bill for CPT code 99490 in January 2015, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) were excluded from participating. However, beginning January 2016, FQHCs and RHCs may now participate in the program and receive an additional payment from CMS for the costs of services that are not already captured in the RHC all inclusive rate or the FQHC prospective payment system for chronic care management services to Me...

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HIMSS 2016 Round-Up

HIMSS 2016 Round-Up

HIMSS 2016 was a whirlwind of activity, from the opening session to the closing remarks. Not surprisingly, Las Vegas as the host city only added to the usual excitement. With conference activities sprinkled among five levels in the Sands Expo Center, the show was a little tricky to navigate; on more than one occasion what seemed like a brief walk between venues took much more time than expected. But, the real highlights were associated with the hot topics at the show. We’ll highlight three in this blog. Population Health Management...

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5 Healthcare Trends for 2016 Affecting Value-Based Care and Population Health Management

5 Healthcare Trends for 2016 Affecting Value-Based Care and Population Health Management

New healthcare trends in 2016 and in years down the road will affect value-based care and population health management. The healthcare industry continues to evolve, and comes with both good and bad news regarding healthcare costs. A reminder, healthcare costs as a percent of Gross Domestic Product have hovered around 17.5 percent for the last few years. The bad news: costs as a percentage of GDP are projected to increase and reach 19.6 percent by 2024. Conversely, the good news is that the growth in healthcare costs are not due to simple inflat...

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Tips from a Care Coordinator: Navigating Chronic Conditions Through the Holidays

Tips from a Care Coordinator: Navigating Chronic Conditions Through the Holidays

Whether you are a care coordinator, caregiver or a family member of someone who is getting up in age, chances are you know someone with chronic conditions. During the holidays, many factors affect the people around us, especially those with chronic health conditions. Whether it's the holiday blues, traveling out of town or trying to manage diet restrictions and other self-care measures, these are all things that need to be monitored with extra care over the holidays. Here are some tips on navigating chronic conditions during the holiday season....

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Why Chronic Care Management is the Future of Health Care [Infographic]

Why Chronic Care Management is the Future of Health Care [Infographic]

In 2012, about half of all Americans suffered from some sort of chronic disease, such as diabetes, heart disease, or lung disease. In addition to this excessive amount of people suffering, the health care system is suffering as well. $3 out of $4 in health care are spent on chronic disease. Reducing and better managing chronic diseases has the potential to improve the lifestyle of millions of adults in the US while also cutting costs for healthcare providers.  In recent years, the growing epidemic of chronic disease in America has not g...

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4 Ways to Increase ROI With Chronic Care Management & CPT Code 99490

4 Ways to Increase ROI With Chronic Care Management & CPT Code 99490

Today, approximately 117 million people - about half of all adults - suffer from one or more chronic health condition and one in four adults have two or more chronic health conditions, such as asthma, diabetes and congestive heart failure. Although these are some of the most common illnesses among the population today, they are becoming more and more manageable due to preventative measures taken by both physicians and healthcare entities as well as patients. With the introduction of CPT code 99490 on January 1, 2015, CMS began reimbursing fo...

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How to Meet CPT Code 99490 Requirements for Chronic Care Management & Get Reimbursed by Medicare

How to Meet CPT Code 99490 Requirements for Chronic Care Management & Get Reimbursed by Medicare

By Ron Ritchey, M.D., Chief Medical Officer One of the most significant pieces of federal stimulus for providers and Medicare beneficiaries, CPT code 99490, began on January 1, 2015. If you are interested in being reimbursed by the Centers for Medicare and Medicaid Services (CMS) and the ability to increase revenue by as much as $250,000 per year, please read on. How to Qualify for Medicare Reimbursement With CPT Code 99490 At the beginning of this year, the Centers for Medicare & Medicaid Services began reimbursing chronic care manag...

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How Predictive Health Modeling Can Help Your ACO Lower Costs

How Predictive Health Modeling Can Help Your ACO Lower Costs

By Ila Sarkar, Ph.D., Director of Corporate Analytics Predictive health analytics, as a whole, is still in its infancy.  In 10 years, the product landscape will look much different than it does today.  Analytics will allow for much greater use of real-time data from a wider stream of data sources, and be available real time to patients in some form.  That said, the use of predictive analytics is already helping providers to identify high-risk patients and manage them so they don’t consume healthcare resources and drive up...

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New CMS Funding Allows ACOs To Fill Infrastructure Gaps With High-Touch Solutions

New CMS Funding Allows ACOs To Fill Infrastructure Gaps With High-Touch Solutions

by Ron Ritchey, M.D., Chief Medical Officer   Accountable care organizations looking to strengthen their population health management programs should strongly consider two new Affordable Care Act initiatives as a real jumpstart to get their infrastructure going. The Centers for Medicare & Medicaid Services (CMS) announced these new initiatives earlier this year as a way to encourage quality improvement and care coordination.  ACOs and physicians (especially those in rural areas) will provide a tremendous benefit to the patients...

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Why ACO Quality Has Improved – And Why Financial Performance Lags

Why ACO Quality Has Improved – And Why Financial Performance Lags

By Ron Ritchey, M.D., Chief Medical Officer   The recent CMS report on the quality and financial savings achieved by Shared Savings and Pioneer ACOs was both unsurprising and instructive for all stakeholders. According to the report released last week (which include performance for about 250 organizations), ACOs launched in 2012 reduced spending by $817 million to date, with hospitals and doctors keeping about $445 million as a result. However, performance on quality improved for 28 of the 33 measures. These numbers are instructive for a...

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