Vigilance Health will be a presenter along with Dr. Anthony Fauci, Dr. Farzad Mostashari, and Dr. David Nash, MBA founding dean of Jefferson College of Population Health (JCPH) along with many more at the “Virtual Summit on Health System Recovery from the COVID-19 Pandemic.”
The summit will engage leading health system experts in a real-time dialogue on Pandemic Recovery and the Future of Health Care in America.
Vigilance Health was invited to discuss the success of Population Health Services from the field and how these services support a rapid recovery from COVID-19 Pandemic.
Click the link below and join us at the Virtual Summit for some fascinating insight andtakeaways. Vigilance Health's presentation is scheduled for Thursday, June 25th at 1:15 pm EDT.
Health care Providers register at no cost: https://healthsystemcovidrecovery.com/caretakers/
Other Registration: https://healthsystemcovidrecovery.com/registration/
[/vc_column_text][/vc_column][/vc_row]The following infographic depicts Medicare’s General Care Management program as well as the potential revenue an FQHC and RHC can generate annually for providing these services to their patients. By reimbursing community health centers, Medicare is incentivizing better management of chronic conditions to reduce healthcare costs, increase quality of care, and improve patient health outcomes.
Review this healthcare infographic for information about this leading value-based, population health management program.[/vc_column_text][/vc_column][vc_column width="1/6"][/vc_column][/vc_row][/vc_section][vc_row css=".vc_custom_1528129724013{margin-left: -20px !important;}"][vc_column][ut_animated_image size="full" hide_image_title="no" image="3609" css=".vc_custom_1528131149518{margin-left: 0px !important;border-left-width: 0px !important;padding-left: 0px !important;}"][/vc_column][/vc_row]What is Remote Patient Monitoring (RPM)?
Remote Patient Monitoring (RPM) is a technology to enable monitoring of patients outside of conventional clinical settings (e.g. in home), includes data filtering, analysis, and alerting, and supports geographical scope and clinical reach. This method of clinical delivery increases access to care, improves care quality and decreases healthcare delivery costs. Monitoring programs can help keep people healthy, allow older and disabled individuals to live at home longer, and postpone the requirement for a skilled nursing facility. RPM can also serve to reduce the number of hospitalizations, readmissions, and lengths of stay in hospitals—all of which help improve quality of life and contain costs. On Nov. 2, CMS released their final rule for the FY 2018 Physician Fee Schedule, announcing:- A standalone CPT code (99091) for remote patient monitoring, offering reimbursement for a minimum of 30 minutes per month spent interpreting patient biometric data from devices such as ECG, blood pressure, and glucose monitors.
RPM is not a Telehealth service
RPM services are not considered a Medicare Telehealth service. Instead, like a physician interpretation of an electrocardiogram or radiological image that’s been transmitted electronically, RPM services involve the interpretation of medical information without a direct interaction between the practitioner and beneficiary. As such, Medicare pays for RPM services under the same conditions as in-person physicians’ services with no additional requirements regarding permissible originating sites or use of the Telehealth place of service (POS) 02 code. RPM services do not require the use of interactive audio-video, nor must the patient be located in a rural area, and the patient can receive RPM services in their home. These new remote monitoring innovations are changing the way healthcare is delivered—and they’re improving outcomes—which is one of the key measures driving payments and reimbursements in today’s value-based landscape. Key takeaways from CMS guidance on how to get credit for this activity:- Clinicians can provide ongoing guidance and assessments for patients outside of in-office visits using digital tools, including the collection and use of patient generated health data.
- Clinicians must use health technology platforms and devices that gather patient data as part of an “active feedback loop” which CMS defines as “providing PGHD in real or near-real time to the care team, or generating clinically endorsed real or real-time automated feedback to the patient.”
- Platforms and devices used for this improvement activity must be, at a minimum, “endorsed and offered clinically by care teams to patients to automatically send ongoing guidance (one way).”
- CMS makes a distinction between technologies covered by this activity, versus “passive platforms or devices” that collect but do not transmit PGHD in real-time. The latter is not eligible technology under this activity.
The rise of chronic disease
When the traditional model of medicine was established, the primary health problems were acute infectious diseases: tuberculosis, typhoid, and pneumonia. At that time, the “one doctor, one cause, one treatment” paradigm was effective at restoring health for these types of health problems. Today, non-communicable diseases such as heart and respiratory disease, cancer, obesity and diabetes are responsible for an estimated two-thirds of premature deaths around the world. Effectively treating these conditions requires a collaborative care model and health care coaching is a key component. Consider these statistics:- Seven of ten deaths in the United States are caused by chronic disease.
- In America, one in two have a chronic disease; one in four have multiple chronic diseases
- Since 1994, children with chronic disease more than doubled (from 13% to 27%)
- The United Nations estimates—on top of the social and psychological burdens of chronic disease—the cumulative loss to the global economy could reach $47 trillion by 2030 if things remain status quo.
- Although chronic diseases are often multifactorial, an estimated 85 percent of chronic disease can be explained by factors other than genetics.
The need for change
It’s clear that chronic disease is the single biggest threat to our health today. More than anything else, behavior change is needed if we want to prevent and reverse chronic disease. According to the CDC, the top five behaviors for preventing chronic disease include not smoking, getting regular physical activity, consuming moderate amounts of alcohol or none at all, maintaining a normal body weight, and obtaining sufficient sleep daily. But as of 2013, only 6.3 percent of Americans engage in all five of these health-promoting behaviors. Why? Because change is hard. It’s not that people don’t want to change and improve their quality of life, they just don’t know how to do it successfully over the long term. The truth is, most people need help creating healthier habits and lifestyle changes.What is Health or Wellness Coaching?
Health coaching is often defined as helping patients gain the knowledge, skills, tools and confidence to become active participants in their care so that they can reach their self-identified health goals. Trained health coaches use evidence-based conversation techniques, clinical interventions and strategies to actively and safely engage patients in health behavior change, especially those with one or more chronic conditions. The Centers for Disease Control and Prevention define wellness as "the degree to which one feels positive and enthusiastic about life”. Health or wellness coaching is a process that facilitates healthy, sustainable behavior change by challenging a client to develop their inner wisdom, identify their values, and transform their goals into action. They utilize the principles from positive psychology and appreciative inquiry, and the practices of motivational interviewing, goal setting and accountability. The familiar adage “Give a man a fish, and he eats for a day. Teach a man to fish, and he eats for a lifetime,” illustrates the difference between rescuing a patient and coaching a patient. In acute care, rescuing makes sense: surgery for acute appendicitis or antibiotics for pyelonephritis. For chronic care, patients need the knowledge, skills and confidence to participate in their own care. Otherwise, the effectiveness of treatment is limited.Why can’t doctors help with behavior change?
Simply put, physicians lack the time and training. The average visit with a primary care physician lasts 10 to 12 minutes—barely enough time to review the patient’s current medications, ask them about new symptoms, and prescribe a new drug. It’s not even close to the amount of time necessary to identify areas for improvement, assess a patients diet, behavior, and lifestyle. Even if they make the time during a visit, how are they going to provide the support necessary for sustaining these changes? The reality is, most doctors, nurses, and physician assistants aren’t trained in behavior change. Instead, they are trained in the “expert” model of care, where they simply tell patients what to do and expect them to do it. This approach works for acute health issues, but fails for long-term behavioral changes like managing stress, starting an exercise routine, or losing weight. For most people, information itself does not change behavior. Also, there aren't enough physicians to address the problem. It’s estimated that we'll have a significant shortage of primary care physicians by the year 2025. If that’s true, we’ll need them to practice at the top of their license and focus on activities specific to their training; like interpreting lab results, making diagnoses, and recommending treatment plans. Finally, health and wellness coaches are an incredible asset to any clinical practice. But unfortunately, most clinics lack the staff, training and technology to support these efforts. They don’t have the infrastructure in place to effectively treat patient health before, after, and in-between care encounters.Here’s where we can help.
Vigilance Health care managers are trained in healthcare coaching and motivational interviewing techniques to effectively help patients become partners in their own care and empower them to make positive changes to their health. Our suite of services compliment—rather than replace—a physicians supporting staff, and don’t require upfront costs, staff increases or capital investments. The Vigilance care team performs as an extension of a private practice or health system, brings with them today’s leading population health and care management technologies, and provides care programs that address patient health in-between visits as part of our care management program. This not only helps free up physician time and improve patient care, it offers health care organizations a low-risk way to gain experience and proficiency with population health management and value-based reimbursement models. Moreover, partnering with Vigilance Health will help create several new revenue streams to make this transition with the least amount of financial and operational discomfort. For detailed guidance on how to begin the transition to value-based care using the Vigilance Health Chronic Care Management program, please contact us here to schedule a complimentary consultation with a Vigilance Health Care Management Specialist.- HEALTHCARE COACHING — Can be defined as helping patients gain the knowledge, skills, tools and confidence to become active participants in their own care so they can reach their self-identified health goals.
- MOTIVATIONAL INTERVIEWING — A gentle form of counseling – which is extremely effective in fostering change in a wide range of health behaviors for all demographics. It works by activating patients own motivation for health changes which significantly improves patient engagement and facilitates a stronger adherence to their Physician’s directives.
- First priority: Ensure patient is adhering to physician’s directives
- Identify any obstacles patient may have adhering to directives
- Ensure the beneficiary’s receipt of all recommended preventative services
- Monitor the beneficiary’s condition (physical, mental, social)
- Provide education and address questions from the beneficiary, family, guardian, and/or caregiver
- Motivate patient and promote self-management and investment
- Identify and arrange needed community resources
- Communicate with home health agencies & other community providers utilized by the beneficiary
- Implementation, maintenance & modification with communication of Care Plan
FOR IMMEDIATE RELEASE April 19, 2018
Dear Vigilance Health partners and future partners, I’m thrilled to be announcing some big news. Vigilance Health is leading the way to realigning healthcare delivery and reimbursement—so our partners can thrive in the new age of accountable care. Our whole team is celebrating today with the launch of our New Population Health Service Lines. Your advice and feedback has been so helpful as we shaped these important new services—thank you! We’re excited to give you the power to take advantage of new value-based care reimbursements and alternative payment methods. Now you can get paid while transitioning to value-based care. But to thrive in this era of health reform, organizations need to adopt a more patient centered approach and provide services offering a high impact on outcome scores. So we combined care management, quality improvement, and practice transformation services with population health IT. This enabled us to provide a "turn-key solution" for healthcare organizations, private practices, and community health centers who see the value of population health services. Here's what you can expect:- These Population Health Service Lines can be launched in just a few weeks, with no financial risk, no provider or staff burden, and no out of pocket expense.
- They will help get your patients (especially those with chronic conditions) better managed, engaged, and able to take a proactive role in managing their health.
- You'll have effective, profitable, and sustainable prevention and wellness programs led by population health nurses and care managers.
- Your organization will be able to generate new revenue streams, increase margins, and improve profitability with quality bonuses and incentives, higher reimbursements, and new FFS payments for PHM services.
- Every healthcare organization is different, so we're also offering several implementation options, each of them tailored to your specific needs.
What is motivational interviewing?
Motivational interviewing (MI) is a counseling approach developed in part by clinical psychologists William R. Miller and Stephen Rollnick. The concept of motivational interviewing evolved from experience in the treatment of problem drinkers, and was first described by Miller (1983) in an article published in Behavioural Psychotherapy. Miller and Rollnick later elaborated on these fundamental concepts and approaches in 1991, in a more detailed description of clinical procedures. Motivational interviewing is a directive, client-centered counselling style for eliciting behavior change by helping clients to explore and resolve ambivalence. It is most centrally defined not by technique but by its spirit as a facilitative style for interpersonal relationship. (Wikipedia:)Why is it used in a care management setting?
If you've ever tried to change your behavior or kick a bad habit, then you know how difficult it can be. Likewise, it's challenging for providers to get patients to adopt and maintain healthful behavior changes; such as losing weight, starting an exercise program, or keeping up with a medication regimen. Historically, clinicians took a more directive approach to care, giving patients a limited role in the decision-making process. But as healthcare continues to take a more patient-centered approach, care managers will need more effective ways to engage patients. Recently, tools like motivational interviewing and programs that use them (such as Vigilance Health's Care Management Program) can help providers influence patients to make changes and support them along the way. With the right technology, care managers can further optimize motivational interviewing and consistently achieve better outcomes, improve care quality, and reduced patient / provider costs.How does it work?
Motivational interviewing is non-judgmental, non-confrontational and non-adversarial. The approach attempts to increase the patients's awareness of the potential problems caused, consequences experienced, and risks faced as a result of the behavior in question. Alternatively, or in addition, care managers may help patients envision a better future, and become increasingly more motivated to achieve it. The strategy seeks to help patients think differently about their behavior and ultimately consider what might be gained if the change is made. The focus is on the present, and entails working with a patient to access motivation—to change a particular behavior that is not consistent with a patient's own values or goals. Warmth, genuine empathy, and acceptance are necessary attributes to foster gains. Another central concept is that ambivalence about decisions is resolved by conscious and unconscious weighing of pros and cons of change vs. not changing. The main goals of motivational interviewing are to engage patients, elicit change talk, and evoke patient motivation to make positive changes. Change talk can be elicited by asking the client questions, such as"How would you like things to be different?" or "How does ______ interfere with things that you would like to do?"Change may occur quickly or may take considerable time, depending on the patient. Knowledge alone is usually not sufficient to motivate change, and challenges in maintaining change should be thought of as the rule, not the exception. For a care manager to succeed at motivational interviewing, they should first establish four basic interaction skills. These skills include:
- The ability to ask open-ended questions
- The ability to provide affirmations
- The capacity for reflective listening
- The ability to periodically provide summary statements to the client.
MI empowers patients to change behavior and commit to better health—on their terms.
Ultimately, care managers must recognize that motivational interviewing involves collaboration not confrontation, evocation not education, autonomy rather than authority, and exploration instead of explanation. Effective processes for positive change focus on goals that are small, important to the patient, specific, realistic, and oriented in the present and/or future. While there are as many variations in technique as there are clinical encounters, the spirit of the method, however, is more enduring and can be characterized in a few key points:- Motivation to change is elicited from the patient, and is not imposed from outside forces.
- It is the patient's task, not the care manager's, to articulate and resolve the client's ambivalence.
- Direct persuasion is not an effective method for resolving ambivalence.
- The counseling style is generally quiet and elicits information from the patient.
- The care manager is directive, in that they help the patient to examine and resolve ambivalence.
- Readiness to change is not a trait of the patient, but a fluctuating result of interpersonal interaction.
- The relationship resembles a partnership or companionship.