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

Improving Care Collaboration and Making Data Available and Actionable across the Connected Healthcare System 

Dr. Fauzia Khan
By Fauzia Khan, MD, FCAP

The mandate to embrace technology has been driven by federal government regulations, as well as disruption of the traditional fee-for-service model. Although we have started to embrace this model in the clinical world, what if these technology platforms could also be effectively used across the entire continuum of care, from the hospital to the home? Over the past decade, technology innovations have continually pushed the boundaries in the healthcare industry.  According to a CDC ... read more