Since 2015 when CMS first introduced the concept of reimbursing patient care provided outside their in-person appointment, more practitioners weighted their options when it comes to implementing such a non-face-to-face care model. Where some decided to set up an in-house system and added CCM to their existing workflow, many were swayed by the pros of outsourcing CCM and opted to contract a third party provider. And although outsourcing chronic care management seems like the easy thing to do, there are several cons to be considered when outsourcing your patient care to a third party.
What are the risks of outsourcing CCM to a third party?
One of the many negatives of not including CCM in your clinic’s workflow is you will lose that personal connection with your patients. Clinics outsourcing CCM will not only be replacing in-person visits with virtual ones but they will also be replacing the trusted care provider with a brand new one. You also lose the control of the level of care your patients will receive and could risk damaging your reputation.
There are also risks of fraud violations. They can cost up to $10,000 per incident and could subject you to jail time as you are directly responsible. Plus it is hard to know what services were actually performed, to what standards and if your chosen provider is actually driving better health outcomes – the main objective often suppressed in favour of guaranteed revenues. Patient privacy and HIPAA rights are always at risk of not being protected in the standard you expect, making it difficult to manage.
And there is the monetary disadvantage. A CCM vendor is paid on volume, not quality. Yet the doctors hold 100% of the risk. On average third party providers are believed to keep from half up to two-thirds of the CCM monthly reimbursement fee, reducing your net payments significantly. Most will not process the reimbursements leaving you with both filing the claim, paying the medical biller and collecting patient co-pays.
Is there an alternative to outsourcing CCM that is easy to implement?
Implementing your own CCM doesn’t have to be hard and finding a platform that simplifies and automates patients on-boarding and management, mitigates many of the disadvantages of outsourcing while giving you all the benefits of an in-house CCM solution without the headaches. The right in-house solution can actually improve your patients health outcomes whilst allowing you keep all your reimbursement based revenues.
The QardioMD remote monitoring platform simplifies CCM and remote patient monitoring and offers many benefits outsources solutions don’t: our hypertension program has been found to be 4 times more effective compared to other brands, as patients using Qardio devices measure more often and longer and the implementation is simple and quick.
Schedule a call with our product team and get a demo of QardioMD platform. You could start generating revenue sooner than you think.
