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Telehealth delivers a win-win when the physician is onboard Print E-mail
Written by Accountable Care Options   
Thursday, 17 May 2018 08:23

The biggest challenge when implementing a telehealth program isn’t patient compliance, it’s participation by the primary care physician. Doctors’ daily schedules are so filled with  patient office visits that unless they set aside time for appointments with patients who have telehealth equipment in their homes, they don’t experience the full benefits that remote health care can provide.

Some physicians are doing a phenomenal job using telehealth to supplant office visits and monitor their patients. We call them our pioneers, and they speak to other doctors about utilizing telehealth, its advantages, and how to integrate it into the workflow. For example, a pioneer might have one day of the week where the office closes at noon. The physician allocates part or all of that afternoon for telehealth assessments.

Physicians quickly learn to give themselves a bit more flexibility because these appointments can take from 15 minutes to an hour. The appointment length depends on the questions they ask and the patient’s circumstances: Was the individual just discharged? Is he or she a surgical patient with multiple chronic conditions? In those instances, a physician should allow more time.

Second, training is essential. Doctors should dedicate time to becoming more familiar with the equipment. It's not difficult to use, but as with all technology, the more one uses it, the more efficient one becomes. We encourage physicians to schedule sessions with us to set up the equipment the way they like it and to learn the best practices for conducting an interview.

Once they embrace the technology, they enjoy having live information, because even when a patient routinely comes into the office, he or she will not have vital sign and glucose readings for every day at home.

Using telehealth data, a doctor can see that a patient has had high blood pressure over the last three days or that today’s reading may be the first sign of a problem. With daily monitoring, the physician can ask more intricate questions and thus get to know the patient much better versus seeing the individual once a month in the office.

Doctors who actively use telehealth say the service benefits the patients, too, because they have the flexibility in their schedules and no longer need a medical assistant to take their blood pressure, pulse and other vitals. This is a win-win situation, because the patient gains independence and the primary care physician realizes better use of time and receives better information on the patient.
 
How to make the most of a post-discharge home visit waiver for chronic care patients Print E-mail
Written by Accountable Care Options   
Thursday, 10 May 2018 09:38

For a select group of doctors associated with Next Generation Accountable Care Organizations, Medicare has increased the number of post-discharge home visits to nine in 90 days from two in the first 30. That greatly benefits primary care physicians with patients suffering from chronic conditions. Best practices make the most of these opportunities to promote patient independence and reduce the likelihood of re-admittance.

In our experience with this program, as a Next Generation Accountable Care Organization, we are conducting three visits for patients in relatively good health. For those with chronic health problems, an additional six visits allows the primary care physician to order follow-ups when the patient’s health declines and to address longer-term needs.

Once a member of our Transitional Care Team conducts the first home visit, the information is reported to the primary care physician for follow-up orders. We try to schedule an appointment with the primary care physician during that visit. If the patient demurs, after we submit that paperwork to the doctor’s office, it's up to the primary care office to schedule the office visit. 

When the patient’s health is unstable, the transitional care team schedules another home visit under the guidance of the primary care physician. These evaluation and management visits tend to be more akin to social service encounters because the registered nurse or ARNP, in concert with a behavioral health professional, is trying to determine whether it is safe for the patient to live independently at home or whether to bring in additional caregivers to assist with activities of daily living. The evaluation and data are reported to the doctor for further follow-up.

One critical question is: Can the patient stay in the home, or has the individual progressed to the point where an assisted living facility might be a better choice? That cannot be answered until the patient is settled in the home. Sometimes, problems don’t present themselves within the 30-day window that Medicare provides for two visits for physicians who are not part of a Next Generation ACO. [non-sequitur. I believe the waiver allows for nine visits within ninety days and they might all be provided in that 30 day period]

In every patient contact, whether medical or social service focused, the primary care physician receives a full report with recommendations and a plan of care as to which services are needed. The plan must be patient-tailored. If the individual needs to be moved to an assisted living facility, the doctor schedules an office visit with the patient and his or her family.
 
Following five healthy lifestyle habits may increase life expectancy by decade or more Print E-mail
Written by Harvard.edu   
Friday, 04 May 2018 17:07

Maintaining five healthy habits-eating a healthy diet, exercising regularly, keeping a healthy body weight, not drinking too much alcohol, and not smoking-during adulthood may add more than a decade to life expectancy, according to a new study led by Harvard T.H. Chan School of Public Health. Researchers also found that U.S. women and men who maintained the healthiest lifestyles were 82% less likely to die from cardiovascular disease and 65% less likely to die from cancer when compared with those with the least healthy lifestyles over the course of the roughly 30-year study period. The study is the first comprehensive analysis of the impact of adopting low-risk lifestyle factors on life expectancy in the U.S. It was published online April 30, 2018 in Circulation.

Read More

Last Updated on Monday, 11 June 2018 13:46
 
Blue Distinction Total Care Doctors, Hospitals and Clinical Care Teams Achieve Better Health Outcomes Print E-mail
Written by FHI's Week in Review   
Monday, 30 April 2018 17:10

Blue Cross Blue Shield Association announced, in an April 26, 2018 PR Newswire release, that the Blue Distinction Total Care program, the industry's largest national network of value-based care programs -- accountable care organizations (ACOs) and patient-centered medical homes (PCMHs) -- is outperforming other care providers in key health care quality and patient health metrics since its launch just a few years ago.

Read more in the current issue of Week in Review>>

Last Updated on Monday, 30 April 2018 17:14
 
FICPA Delivers Annual Health Care Industry Conference Print E-mail
Written by Jeffrey Herschler   
Sunday, 22 April 2018 00:00

The Florida Institute of CPA’s held their annual Health Care Industry Conference Thursday, April 19 - Friday, April 20, 2018 at the Caribe Royale in Orlando. Entitled Ongoing Change. Ongoing Learning., this year's conference promised to help financial professionals keep pace with this ever-evolving industry. Speakers included Erin Aebel, Warren E. Beck, Rebecca O. Burch, Jamie M. Burgess, CPA, CISSP, CISA, Eric J. Busch, MBA, CPA, John D. Couris, Lynda M. Dennis, PhD, CPA, CGFO, Andrew S. Feldman, Charles Felix, CPA, CFF, Wilfredo A. Ferrer, Jessika Garis, CHC and Richard J. Lucibella, MHS, MBA. Thursday's Keynote addressed the Tax and Healthcare Legislative Outlook from Washington. Other topics covered were When the Government Comes Knocking, Bundled Payments and Managing Multi-Generational Teams. Mr. Couris delivered a passionate lecture on healthcare consumerism Friday morning while Rich Lucibella offered a spirited presentation on the viability and sustainability of ACO's.

Sponsors were as follows:
  • RSM
  • South Florida Hospital News and Healthcare Report
  • Vaco
  • Carr, Riggs + Ingram 
  • FHIcommunications 
  • J.P. Morgan 
  • Ernst + Young 
  • HFMA 
  • Moore Stephens Lovelace 
  • Navigant Consulting 
  • Pinnacle Health Care
For information on future conferences, please contact the FICPA at (800) 342-3197, (850) 224-2727 or millerd@ficpa.org.

Last Updated on Monday, 23 April 2018 16:39
 
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