Every skilled nursing facility must abide by rules set by Medicare, particularly when it comes to Potentially Avoidable Hospitalizations, or PAHs. In fact, Medicare will soon be changing its reimbursement policy so that if a patient is readmitted to a hospital after a short stay in skilled nursing, the facility is penalized with less reimbursement money through the Medicare program. These changes don’t go into effect until 2019, but skilled nursing facilities are already receiving feedback reports on their performance. More and more, the skilled nursing facility is discovering that telemedicine provides a viable solution for monitoring, assessing, evaluating, and diagnosing patients on site without transferring them out of the facility for care – thus avoiding getting dinged by Medicare in the process.Continue Reading…
Tag: hospital readmission
Guest post by Dr. Andrey Ostrovsky, MD and CEO of Care at Hand
Next phase in the evolution of telemedicine
There is a lot of hype about telemedicine. As the reimbursement landscape matures due to the Medicare Access and CHIP Reauthorization Act (MACRA) and other policy vehicles, the promise of telemedicine is being put to the test.
The good news is that telemedicine has been shown to be clinically effective and financially sustainable in certain settings. However, telemedicine is not always clinically appropriate or commercially viable. It requires a graded approach in each clinical situation in order to
- balance specific patient needs and risks,
- complement the local care delivery processes, and
- align with local healthcare financing environment.
As a pioneer in telemedicine, VSee is partnering with Care at Hand to deliver telehealth that continually titrates the level telemedicine as needed to optimize clinical outcomes, patient experience, and cost effectiveness.
Care at Hand is a predictive insights platform powered by non-medical staff. For payers and providers struggling to optimize margins and achieve the Triple Aim, Care at Hand provides a smart survey platform that identifies early medical and psychosocial risk factors for hospitalization.
Unlike episodic predictive models limited to claims and EMR data, Care at Hand predicts hospitalization risk in the blind spot between doctor visits, using the observations of existing frontline staff.
Office secretaries in the clinic can perform outbound calls to patients guided by the Care at Hand surveys as part of their routine outreach to remind patients about upcoming appointments. The Care at Hand technology will automatically detect if patients are at increased risk for hospitalization and in turn notify the nurse triage line. The physician or other eligible provider can then use VSee to videoconference with the patient for a billable tele-consult. Physician groups stand to increase their revenue and help their patients by using Care at Hand in the following ways:
1) Charge for a reimbursable telemedicine visit
2) Charge for a chronic care management or care transition episode
3) Increase gain-share from reduced admissions due to the early detection and intervention when in capitated contracts with Medicare C plans.
Integrated Delivery Networks (IDNs)
IDNs provide a broader range of services than physician groups allowing for additional capabilities from the VSee and Care at Hand partnership. In particular IDNs that are using call centers to expand their population health management can optimize the cost-effectiveness of those call centers. In particular, as call centers grow, they can either expand by hiring more nurses, or they can expand by hiring much less expensive non-medical staff and use Care at Hand to allow one nurse to supervise 20 non-medical staff.
Furthermore, VSee will be expanding it’s footprint in post-acute care by using Care at Hand to create a bridge between doctors and post-acute care providers. Post-acute providers that staff non-medical workers using Care at Hand will have immediate physician support when elevated risk is detected by the Care at Hand system. The integration of Care at Hand’s light-weight risk-detection through non-medical staff and VSee’s gorgeously simple physician videoconferencing will ensure that patients get the right level of care without overmedicalizing ever small escalation.
The marketplace is demanding precise data to drive care delivery and paying for value from telemedicine vendors. The VSee and Care at Hand partnership allows both of these things to happen.