Care Beyond the Clinic Floor
A physician’s shift might end at 6pm, or 2am, or 8am, but rarely did we see those doctors hang up their coats after sign out. Whether it was meticulously reviewing charts to plan for patients the next day, returning phone calls from patients concerned about their recent visit, or making sure today’s procedure was accurately documented from their earlier voice recording, doctors spent a significant amount of time after-hours — when they weren’t face-to-face with patients — making sure patients had the best possible long-term quality of care.
This was a incredible commitment to high-quality patient care that our team deeply admired. Physicians worked around the clock to care for their patients, but they were only reimbursed for the time they spent face-to-face with patients.
Changes in policy over the last decade amplified this dynamic. Meaningful Use and the Affordable Care Act, along with the transition to Accountable Care Organizations and value-based reimbursements, further incentivize hospitals to reduce readmissions and cost overruns, which often required more physician time behind a phone or desktop.
The Readmissions Reduction Program places a penalty on hospitals that have excess readmission rates within 30 days as an indicator of poor quality care. Penalties range from 1 to 3 percent of all Medicare DRG-related revenue. Similarly, there are incentives for individual doctors under the Medicare Physician Feedback/Value-Based Payment Modifier Program, which rewards or penalizes physicians based on quality and cost metrics. As a result, hospitals and physicians continued searching for ways to keep patients happy and healthy at home.
Federal policymakers, however, understood that while reviewing patient information and conducting follow-up was immensely important, it placed a tough burden on physicians. After years of doctors climbing the learning curve of EHRs without any compensation for it, the Centers for Medicare and Medicaid Services (CMS) announced that they would offer specific CPT codes (99490, 99487, 99489, 99091) so physicians and members of the care team could be reimbursed for remote management of chronic conditions. These codes including reimbursement of between $43–95 per-patient-per-month for collecting and reviewing biometric data from patients passively over a wearable or actively via self-reporting, calling patients and giving them health coaching, instructions, or follow-up over the phone, or reviewing and planning their care in the electronic health record. CMS also approved three new CPT codes earlier this year, to go into effect in 2019, for setting up remote monitoring systems, educating patients on the technology, collecting/evaluating physiological data, and remotely interacting with patients.
This finally gave clinical staff the opportunity to be rewarded for their hard work. However, measuring the requirements for reimbursement, recording times and tasks, and submitting this additional paperwork was still incredibly burdensome, and for most care teams, difficult to accurately and quickly complete.
As a team dedicated to both scaling high-quality patient care and reducing clinical burnout, we wanted to help doctors make a difference and make sure they were recognized for it.
Memora Health’s software now tracks clinician time spent reviewing or responding to messages, records patient data for reimbursement-eligible patients, and prints out reports that care team can send to CMS for remote chronic care management reimbursement along with Stage 3 Meaningful Use and MIPS patient engagement reporting requirements.
Doctors already spend time caring for their patients when they’re away, we’re helping them make their hard work count.
Looking to bring remote care management to your patients? Visit https://memorahealth.com or contact us at info@memorahealth.com, we’d love to chat and learn how we can work together to help your practice and patients.
Memora Health is building the operating system for care delivery that implements intelligent, streamlined workflows and revolutionizes the patient experience outside the care setting. We offer a smart end-to-end platform that unifies fragmented health care data to enable providers, payors, and life science companies to automate care delivery operations — from patient communication to documentation to reimbursement. We uniquely use artificial intelligence to digitize existing care delivery workflows, giving clinicians infrastructure that learns from every encounter they have. Memora supports a full suite of virtual care systems from automated patient intake and scheduling to remote monitoring and care pathways to billing and documentation. Memora is backed by Andreessen Horowitz, SV Angel, Kevin Durant, Martin Ventures, and several healthcare strategic groups.
