Gaining Patient Buy-in for Chronic Care Management

Medicare patients who have two or more chronic conditions account for 93% of total Medicare spending. These patients are found to have higher rates of hospitalizations, pharmacy utilization, and specialist utilization, which increases costs for all stakeholders. Basics of CCMChronic care management (CCM) is a separately billed, non-face-to-face CMS covered service that is designed to be delivered through the primary care setting. To participate in the Medicare program, the patient must have two or more chronic conditions (conditions lasting more than 12 months or until the death of the patient). Physicians are given financial incentives from CMS to talk with …

Why ADT feeds matter and how providers can use them to deliver better care

Lightbeam’s population health management (PHM) platform includes HL7 ADT messages and feeds which transmit critical patient demographic information to help providers stay on top of daily hospital utilizations and see which patients were admitted or discharged from a facility within 24 hours of the event. Why is this information so important? First, it enables providers to know who, out of their patient rosters, has been in hospital care over the past day, week, and even month, and ensure they receive the proper post-discharge care. By using these ADT feeds, care management teams can reach out to these patients via phone …