Patient Engagement – the Urgent Care killer?

By Dr. Mansoor Khan Last month, we started looking at the impact of Urgent Care centers on physician practices. I only started there because a news article had caught my eye. There are, however, multiple other reasons for the steadily declining revenues and squeezing profit margins of physicians. These include payer payment transformation and value-based purchasing initiatives, patient demand for more convenient care delivery modalities, quality incentives/penalties, unfilled practice calendars (27% of available slots go unfilled), losing patients to competitors, to name a few. The response to these conditions however, can’t be more of the same (remember what Einstein said, no not “The hardest thing to understand in the world is the income tax”, though he did say that, but rather “We can't solve problems by using the same kind of thinking we used when we created them.”). So, to survive and thrive practices ... read more

Persivia Announces Distribution Agreement with Henry Schein for its Artificial Intelligence-Based Clinical Decision Support System (CDSS)

LOWELL, MA — May 08, 2018 — Persivia, whose software employs artificial intelligence (AI) to enable earlier clinical interventions and superior cost management, announced today a distribution agreement with Henry Schein Medical Systems, Inc., developers of MicroMD® practice management and electronic medical records software (MicroMD EMR) for medical practices and a wholly-owned subsidiary of Henry Schein, Inc. Henry Schein will distribute Persivia’s health care data analytics software to its medical customers. Persivia’s Clinical Decision Support System (CDSS), powered by the SolitonTM AI engine, will enable MicroMD EMR to deliver real-time, evidence-based alerts, guidelines, and protocols to clinicians to improve clinical quality measure scores (including MIPS, CPC+ and ACO quality measures) and reduce costs. “As the emergence of artificial intelligence and other advanced technologies reshape decision making in clinical ... read more

Urgent care is taking over Primary Care – how will you respond?

By Dr. Mansoor Khan
The business of health care is changing; faster than most of us would like. The Urgent Care sector is projected to grow to over $26 Billion per year by 2023. Between 2007 and 2016 the number of claim lines for Urgent Care grew by 1,725%. Interestingly from 2012 to 2017 the number of patients using non-face-to-face services grew by 600% and is expected to accelerate. You see the pattern(s)? There are actually 2 primary takeaways from this data: 1) Urgent care is taking business from traditional brick-and-mortar care (remember this term from the dot com days?), yes, it is finally happening to medicine! 2) The non-face-to-face visit is growing even faster. I very purposefully use the term non-face-to-face rather than e-visit or telemedicine because the later 2 terms have a lot of reimbursement limitations that make them of very marginal value for the average practice. However, the non-face-to-face visit encompasses ... read more

Final rule for MIPS in Year 2, 2018 is out!

CMS has announced its final rule for the MIPS with comment period for year 2, 2018. With new provisions, CMA has built flexibility into MIPS policies to minimize burden of participation and gear up the clinicians for full implementation in the following year. Here are 7 key things to know that will change MIPS in 2018:
  • Cost gets a weightage
Currently, the performance category weights for the MIPS final score are: 60% quality, 0% cost, 15% performance activities, 25% Advancing Care Information. Next year, quality will be weighted at 50% while the cost at 10%. The cost performance category will be measured against Medicare Spending per Beneficiary and total per capita cost measures. The Improvement activities and advancing care information category weights remain at 15% and 25% respectively.
  • Extended performance period
The performance period for the quality ... read more

CHI chooses Persivia for PHM

arch 21, 2017 08:30 AM Eastern Daylight Time
LOWELL, Mass.--(BUSINESS WIRE)--Persivia, a provider of real-time quality and care management solutions announced today that Catholic Health Initiatives (CHI), one of the nation's largest health systems, has selected Persivia’s Clinical Quality Measures for Meaningful Use and IQR program requirements. The CHI implementation of e-CQMs includes 20 sites across 5 different states, which was deployed in rapid time. The Drummond-certified program will help CHI ... read more

What Comes Next for Chronic Care Management?

By Mansoor Khan, CEO, Persivia The Chronic Care Management CPT code (99490) allows providers to collect approximately $42 per qualified patient per month for providing 20 minutes of non-face-to-face care management services to Medicare beneficiaries that have at least 2 chronic conditions. This, as with most new CMS initiatives, has as its ultimate goal the objective of improving patient outcomes and satisfaction. How do we get from this fee- for-service reimbursement to improved outcomes? The Grand Plan CMS has an overall plan that moves the healthcare system into value-based payments at a breakneck speed. In order to get there, CMS has defined 4 categories of payments which are as follows: • Category 1—fee-for-service with no link of payment to quality • Category 2—fee-for-service with a link of payment to quality • Category 3—alternative payment models built on fee-for-service architecture • Category 4—population-based ... read more

Laying the Groundwork for Implementing a Chronic Care Management Program

By Mansoor Khan, CEO, Persivia

First the numbers:

  • 45% of the world’s population is affected by chronic disease
  • 60% of worldwide deaths are caused by chronic disease
  • 4% of the global annual GDP represents the economic burden associated with chronic disease
  • 17% of the US GDP is spent on healthcare, and chronic disease makes up 75% of this expense
  • 80% of chronic disease can be prevented
The numbers are staggering, so what do we do about this? Well, as individuals we can exercise more, eat better and lose weight, but that is not what I am asking. I mean what do we do as a society? Fortunately, the healthcare industry as a whole is working on the problem. However, in this, and successive blogs, I will focus on the path that CMS is taking to address the issue of Chronic Disease Management.

What is CMS Doing About it?

As we all know now, CMS launched the now CPT ... read more

Population Health, Care Management & Clinical Surveillance at the Heart of HIMSS 2015 Buzz

CEO Mansoor Khan
CEO Mansoor Khan

CEO Dr. Mansoor Khan Provides His Observations from the Show Floor
Q: What did you take away as the biggest changes ahead for the healthcare industry in 2015?
A: Population health management and how providers and clinicians can more effectively manage patients, and their data, were some of the main issues that I had addressed at the show. In the past, we had focused on the provider data, which essentially was "dirty data" that needed better ways to be captured, normalized and then interoperate across healthcare systems and into clinical workflows. But on the horizon, the biggest challenge will be around ... read more

The Evolution of Patient Engagement and Chronic Care Management

Patient and Clinician By Fauzia Khan, MD, FCAP
As the healthcare industry continues a positive shift toward value-based care and away from the fee-for-service model, payers and providers are starting to look at patient engagement and managing chronic conditions very differently. Previously, disease management was measured more by associated cost such as procedures ordered, in-patient stays and re-admissions, and patient engagement typically consisted of generalized letters that described their disease and standard therapies. These letters were a one-way communication and hardly fulfilled the notion of “engagement.” There have been great strides made recently in developing patient-centric, IT solutions such as electronic health records, ... read more