- You're interested in providing
a Principal Care Management program at your practice,
but you might be wondering
if it's a worthy investment of your time and resources.
In this video, we're going to break down
the return on investment
for a Principal Care Management program
to break down costs and reimbursement,
to decide whether or not this is a good fit for your group.
(upbeat music)
Hi, this is Loran with ThoroughCare.
Every day, we're helping practices manage,
bill and streamline care management programs
just like Principal Care Management.
Offering a PCM program can be extremely beneficial
for your patients, practice and your bottom line.
We're going to discuss the reimbursement opportunities
of this program, how it can cut costs,
and how it can ultimately affect
your outcome based revenues.
Before this video, if you'd like to learn more
about Principal of Care Management and the CPT codes?
Check out this video here.
So, let's first start with taking a look
at the revenue opportunity for Principal Care Management.
With this ROI example, we're going to use CPT code 99426,
which is the clinical reimbursement code
for managing one chronic condition.
CPT code 99426 pays about $61 monthly per billable patient.
If 250 patients receive PCM services in a month,
that's about $15,250 in revenue a month,
which equates to $183,000 yearly.
So, what are your costs?
You'll need a care manager to run this non-complex service.
Each care manager can manage up to 250 patients a month.
The annual salary of a care manager
that can manage these patients is around $40,000.
Subtract that for from the total,
and that's about $143,000 yearly reimbursement.
So what are some actual numbers
that ThoroughCare sees for patient participation?
Well, it really is hard to predict,
but what we see every day
is about 30 to 50% patients participating in this program
that are eligible for these services.
So, even 30 to 50%
is still a great reimbursement opportunity
for your practice.
Another reimbursement opportunity,
is to bill Principle Care Management in tandem
with other care management programs.
A great example of this would be billing
with the remote patient monitoring codes
if you give a patient a monitoring device.
Together, both offerings can be
an effective healthcare solution.
As your patient works with your practice
to address their chronic condition,
Remote Patient Monitoring can provide a stream
of data to inform better care decisions.
Often, RPM is used to monitor chronic conditions
by collecting patient vitals daily.
So, with both programs, you can improve patient conditions
and create revenue for your practice.
Check out our ROI for RPM video,
and our learning center in the description below
to find out more about revenue opportunities
for remote patient monitoring.
So, how else can a Principal Care Management program
increase reimbursements while cutting costs for patients?
While the phrase "return on investment,"
usually holds a financial connotation,
a return isn't entirely dependent on monetary value.
General benefits are equally important,
your patients will benefit from PCM
because it places a preventative eye on their health.
Principle Care Management improves access
to their primary care team
and strengthens care coordination.
Principle Care Management can also address
the broad implications of chronic disease
and the burden it places on our healthcare system.
Chronic conditions can lead to additional illnesses
and health complications.
Minimizing office, or hospital time,
is a crucial point of value.
Allowing patients to stay at home,
there's less pressure on your staff
and there are more opportunities for high risk patients
to be seen.
On the providers side,
this benefit plays right to the goal
of value based healthcare.
Reduced hospital visits
can help satisfy certain performance indicators
measured by Medicare.
This can help providers sustain
or improve their MIPS scores,
which can raise reimbursement rates.
As you can see, offering a Principal Care Management program
can increase revenue.
And if offered with other care management programs,
can increase access to patient care
and reduce overall costs.
We believe the PCM program more than pays for itself.
So, now that you have a better understanding
of Principal Care Management's return on investment,
what should you do next?
If you'd like to take a deeper dive,
there's a link below to our learning center,
which is filled with clinician articles
regarding the programs we support,
including Principal Care Management.
Or if you're ready to talk about
how Care Coordination software can help you run and manage
a Principal Care Management program?
Reach out to one of our representatives at the link below,
or feel free to leave a comment.
Don't forget to like this video, and we'll talk to you soon.
Thanks for watching.
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