Care Management Blog

The Centers for Medicare & Medicaid Services (CMS) launched Z codes in 2015. They are a set of ICD-10-CM codes that identify non-medical factors that may affect a patient's health status or ability to fully benefit from treatment. They were released for billing and research purposes, yet no reimbursement is associated with their use.

The US Center for Disease Control and Prevention defines health literacy as "the degree to which individuals have the ability to find, understand, and use information and services to inform health-related decisions and actions for themselves and others."

In this video, we break down everything you need to know to successfully start a Remote Patient Monitoring (RPM) program.

A patient’s chronic illness journey is cyclical and complex. It's not a linear path but a continuous loop of pre-service, service, and post-service interactions with the healthcare system. Without adequate self-management, health literacy, and personal discipline, a patient’s health can deteriorate, and their condition worsens significantly.

The Centers for Medicare & Medicaid Services (CMS) created the Shared Savings Program (SSP) to encourage physician groups, hospitals, and other healthcare providers to support more coordinated, high-quality, and cost-effective care.

When deciding to start a new care management program or scale an existing one, there are many questions to answer, including:

Health plans have extensive experience with care management, technology, and pilots. However, what’s new is leveraging all three to better collaborate with providers to enhance Chronic Condition Management, engage and activate members more deeply, and facilitate overall cost savings.

Care management program success depends on keeping patients actively enrolled in the program until they achieve their health and wellness goals, their health risk decreases, and they can confidently self-manage their chronic conditions. When this happens, they can graduate from the program and return to traditional disease management.

Health systems are looking for ways to improve care outcomes and patient experiences while building cash flow and enhancing pay-for-performance.

Chronic kidney disease (CKD) is growing in prevalence, impacting more than 37 million Americans. More than 100,000 of these patients begin dialysis each year and 20% of those diagnosed die from the disease or its complications. At an annual cost of $114 billion annually, CKD is one of the most expensive chronic illnesses.