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HEALTH CARE, FOR INDIVIDUAL PATIENTS AND AS A SYSTEM, IS A TEAM
EFFORT. WE BELIEVE THAT CARE COORDINATION IS THE KEY.

Sample Revenues per Provider

  • Earn additional revenue with no upfront capital investment.
  • Earn additional revenue by scheduling Annual Wellness Visits to initiate or update patients’ Plans of Care, needed to provide Chronic Care Management services.
  • This revenue does not even include the cost savings for decreasing preventable re-admissions and emergency department visits.
  • The following is a typical example of revenues available to a single provider 
    Sample CCM Revenue Calculation1 (MONTHLY) Value Formula
    CCM reimbursement rate (national average) $42.91 A
    Average number of Medicare patients per provider 716 B
    Estimated % with 2+ chronic conditions 75% C
    Average % of eligible patients consenting to service 80% D
    Est. gross monthly reimbursement revenue $18,434 E = A*B*C*D
    1. Data from CMS, American Academy of Family Practice, Kaiser Family Foundation
    Sample Annual Wellness Visit (AWV) Revenue Calculation (ANNUAL) Value Formula
    AWV reimbursement rate (national average) $173.41 F
    Average number of Medicare patients per provider2 716 B
    Est. gross annual reimbursement revenue $124,162 G=F*B
    1. Per CMS, all Medicare patients qualify for an Annual Wellness Visit, including CCM patients

     

    Sample TCM Revenue Calculation (ANNUAL) Value Formula
    TCM reimbursement rate (national average of moderate- and high-complexity)3 $198.98 I
    Sample inpatient discharges per year4 245 J
    Est. gross annual reimbursement revenue $48,750 K=I*J
    1. Average of TCM-High complexity ($232.41 per discharge) and TCM-Moderate complexity ($165.54 per

        discharge)

    1. Eligible discharges from the following types of facilities: Inpatient Acute Hospital, Inpatient Psychiatric Hospital, Long Term Care Hospital, Skilled Nursing, Outpatient Observation or Partial Hospitalization, Partial Hospitalization at Community Mental Health Center.  Eligible patients include those patients returned to patient’s home, domiciliary, rest home, or assisted living.  CMS estimates that approximately 34.3% of eligible Medicare beneficiaries are admitted to a hospital or utilize emergency department annually. http://www.healthindictators.gov/indicators/Hospital-inpatient-Medicare-admissions-per-1000-beneficiaries_2001/Profile/ClassData

     

  • Primary care providers in private practice, a clinic network or within a Hospital setting
  • Providers of care to Medicare recipients with 2 or more chronic illnesses
  • Providers who make use of an EHR as a means of maintaining patient records
  • Providers who use plans of care to manage their patients’ chronic illnesses
  • Providers who want to improve the quality of life for their Medicare patients

 

    Care 24/7 assists providers in the following ways:
  • Improves clinical outcomes and strives to increase patient compliance
  • Helps providers deliver and receive reimbursement for coordinating patient care
  • Monitors patients on a monthly basis, helping providers stay informed of patient activities and concerns between appointments. This translates into a better relationship between patient and provider and patients following their care plan
  • Software tracks all activity and communication between our Wellness Coordinators and patients. As a result, auditable reports are sent on a monthly basis to utilize in monthly CMS billing
  • Helps providers achieve Patient-Centered Medical Home recognition. As a PCMH provider, you will be eligible for additional private insurer revenue for these same services
  • Provides the staff necessary for your facility to offer Chronic Care, Transitional Care and Clinical Advisory services to your qualified patients

 Click here to see our full portfolio of services.