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Simplifying the Management of Complex Care Patients

Simplifying the Management of Complex Care Patients

It’s complicated…

Having a chronic illness is tough. Having multiple chronic conditions is even tougher.  Add financial, emotional, mobility or behavioral factors, and it can seem insurmountable.

People who struggle with multiple ongoing health challenges (like diabetes, congestive heart failure, chronic obstructive pulmonary disorders, etc.) have complex needs and are by far the heaviest users of emergency departments, in-patient facilities, and urgent care centers. In fact, complex care patients account for roughly ⅔ of every dollar spent in the health care system today.

How to Set Up a Chronic Care Management (CCM) Program

How to Set Up a Chronic Care Management (CCM) Program (A Five-Step Guide)

The Case for Chronic Care Management (CCM)

If you are reading this article, I am assuming you are convinced of the value of Chronic Care Management (CCM) programs. If that’s indeed the case, please proceed to Step 1 (below), which acts as the genesis for understanding CCM and formulating an appropriate strategy to realize its value. But first,…

Medicare needs to increase access to telehealth

Within one year, the U.S. Department of Health and Human Services must propose regulations that adjust the network adequacy requirements for Medicare Advantage plans to factor in access to telehealth services per a Trump Executive Order.

By Dr. Amit Phull 1 Comment / Oct 14, 2019 at 9:00 AM

On Oct. 3, President Trump signed an Executive Order outlining measures for Medicare reform— specifically telehealth for seniors — through network adequacy in Medicare…

Brian Donohue column: The potential of telehealth for cancer patients in Virginia

A cancer diagnosis changes everything. First, you receive this earth-shattering news and then, you enter the maze of cancer care, with countless visits to specialists and other health care providers to discuss which treatment options are appropriate for you. Fortunately, there are options, thanks to scientific research and clinical trials. But no matter where you live, you may encounter logistical challenges reaching everyone on your treatment team. Clinicians, survivorship specialists and researchers running clinic trials may be miles away or may necessitate a lengthy trip.

Cancer requires constant care from and communication with your…

Bipartisan support keeps telehealth adoption moving forward

Over the last decade, few issues in politics have been more polarizing than healthcare. It’s driven a deep wedge between Democrats and Republicans, particularly following the passage of the Affordable Care Act (ACA) and the subsequent efforts to repeal it, and has caused rifts within those parties.

Yet despite all the animosity, there is one subset of healthcare that has had the opposite effect, pulling ample support from both parties to drive multiple initiatives forward: telehealth. Whether it takes the form of remote patient monitoring (RPM), online video discussions between patients and providers (telehealth),…

Lots to Like in the Executive Order on Medicare

On October 3, President Trump issued an executive order on “protecting and improving Medicare for our nation’s seniors.” For now, it’s only a statement of intent, but there’s quite a bit to like among the stated intentions.

I’ve long argued that both Republicans and Democrats focus too heavily on the demand side of health care — specifically federal health insurance law. Both sides largely ignore the supply side — how we actually deliver care. For this reason, I’ve criticized some previous initiatives by the Trump administration and its Republican allies in Congress, such as…

California Expands Medicaid Tele-Health Policy

The California Department of Health Care Services (“DHCS”) recently revised its Medi-Cal telehealth policy to allow providers increased flexibility in their use of telehealth as a modality for delivering medically necessary services to their patients. The policy is retroactively effective as of July 1, 2019, and fee-for-service providers must submit claims for services provided via telehealth according to the new policy. Updates to the telehealth policy include the following:

  • Reimbursable Modalities: Providers now decide what modality (either live video or store-and-forward technology), they want to use to deliver eligible services to a Medi-Cal enrollee as long…
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