The 2017 Physician Fee Schedule is here and clearly states that CMS wants to increase reimbursements for managing chronically-ill patients. A new avenue for reimbursement is non-face-to-face care, first introduced in 2015 with CPT 99490 and expanding in 2017 to include higher payments for medically complex patients and behavioral health.
Signallamp Health dedicates RNs to collaborate with the patient’s own PCP to provide care management services in between office visits. Such patient engagement is an important step in preparing practices for the added requirements of MACRA.
In this series, Signallamp Health highlights the positive impact of its hands-on approach.
Patient Overview
Demographics: 72 year-old male with COPD
Potential complications: lung disease, heart failure, collapsed lung and sleep problems
Assessment
In 2013, COPD was the third leading cause of death. Tobacco smoke is a key factor in the progression of the disease, however many patients have trouble quitting on their own.
The physician chose to enroll this patient in Signallamp Health’s chronic care management program. This program provides additional attention to the patient’s conditions along with the regular office visit. Linda, a registered nurse with Signallamp Health, understands that helping to change a behavior is very challenging without support.
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When Linda first connected with the patient, the patient was smoking 1 ½ packs of cigarettes a day and patient was not interested in quitting. Linda educated the patient regarding the link between smoking and COPD exacerbations. Linda’s encouragement, after eight months, motivated the patient to cut back on smoking. Linda also helped obtain nicotine patches and provided ongoing support during this challenging lifestyle change.
“With every call, I asked him how he was doing with his attempts to reduce his smoking and always encouraged him,” Linda said. “He finally started to cut back and said the coaching really helped.”
The Result
The patient reduced smoking from 1 ½ packs to a 1/2 pack per day and reported feeling better.
The patient continues to smoke; however, he has set a goal to cut back even further. Smoking cessation is his ultimate goal.
