To improve patient care and drive greater revenue for healthcare providers
CloudMedx, a healthcare technology company improving patient care through advanced data analytics, today announced the release of breakthrough capabilities for healthcare providers to deliver chronic care management (CCM) to Medicare beneficiaries. The new capabilities help medical practices automatically identify, enroll, track and improve care and treatment for eligible CCM patients through intuitive data integration and intelligent risk stratification. The CCM capabilities are now available through the CloudMedx Analytics Platform.
The Centers for Medicare and Medicaid Services (CMS) estimates that two-thirds of Medicare beneficiaries have two or more chronic conditions. These patients are eligible for CCM services, which provide at least 20 minutes of non face-to-face clinical staff time per month, directed by a qualified health care professional. CMS pays these care providers for delivering CCM services as they alleviate costly future events such as complications, hospital readmissions and emergency room visits.
However, based on CMS data, of the approximately 35 million Medicare beneficiaries who qualify for CCM, the agency only received reimbursement requests from 100,000 beneficiaries (Modern Healthcare, October 17, 2015). This poor CCM utilization is driven by lengthy documentation, lack of data analytics, upfront costs, as well as patient variation and pushback. Many clinics are already collecting the necessary information on their patients that are eligible for CCM, but have not dedicated the resources needed to make the program viable. The situation is impacting patient health and practice group revenue as patients are not being contacted in time. For example, an eligible population of 5,000 CCM patients per month could potentially generate $2.1 million in annual recurring revenue for a provider group based on the $40 to $43 billable code for CCM.
The CloudMedx analytics platform helps alleviate this issue for care providers, putting its advanced analytics engine to work for them. The company has automated the workflow of identifying, stratifying, enrolling, and communicating with patients directly through its portal. CloudMedx also offers APIs through which providers can enjoy the benefit of its platform integrated directly into existing workflows and EHRs.
“We built this feature based on customer demand,” said Sahar Arshad, COO and Co-Founder of CloudMedx. “Upon looking at the CCMs, we felt it was underserved and the primary drivers for it were the lack of systems talking to each other and analytics that surface them automatically. For us this was a quick development as we had all the core functionality already built in the backend. But this feature added an additional revenue stream for our partners and improved their clinical operations. Imagine if you are able to identify your chronic patients automatically and talk to your chronic patients and guide them towards better health – it helps keep them healthy and brings potential high costs down such as avoidable readmissions, missed medications, and other concerns at bay. Since our roll out we have seen a huge uptake for this feature from both our enterprise customers as well as groups of providers.”
About the platform and CCM features
CloudMedx combines the power of machine learning and big data analytics to generate real-time health insights and improve patient outcomes by removing any gaps in care and treatment. Using predictive risk analyses, CloudMedx helps physicians identify people who are at risk for costly, debilitating illnesses in time for intervention and one-on-one support that can help them reverse their risk or minimize their potential for serious complications.
The CloudMedx analytics platform integrates with labs, pharmacies and hospitals to capture all relevant clinical and financial information at the point of care, which is then shared with all necessary healthcare participants across the continuum. CloudMedx helps address a number of challenges that medical care organizations face including excess readmissions, reimbursement reduction due to value-based payment programs, poor patient satisfaction scores, inefficient care processes, and poor, prescriptive population health management.
With the new CCM capabilities, healthcare professionals can quickly identify patients who qualify for CCM, engage them in care plans and generate daily and monthly reports on specific CCM activities, such as calls made, time sent and associated eligible payments.
Key new features within the CloudMedx Analytics Platform that support CCM include:
- Patient engagement – in real-time identify, stratify, and enroll eligible patients through an automated process;
- Curated care plans – use industry standard suite of care plans or create new highly targeted care plans for individual or groups of patients under a disease registry;
- Tie together information workflows – integrates EOC documents, time analysis and multiple EHRs into the care coordination workflow;
- Staff coordination – directs the staff to focus on immediate tasks at hand and empowers technology partner to provide a scalable solution for non-office care coordination.
CloudMedx analytics platform empowers healthcare organizations to deliver improved patient care and outcomes through greater insights. CloudMedx combines the power of machine learning and big data analytics to generate real-time health insights and improve patient outcomes for conditions that are responsible for as much as 90% of healthcare costs: congestive heart failure, stroke, hypertension, heart attack, chronic obstructive pulmonary disease, pneumonia and diabetes. Located in Palo Alto, CloudMedx is a private company and received seed funding from Y Combinator. More information is available at www.cloudmedxhealth.com.