.jpg "Daniel Godla")
This series shares ThoroughCare’s Growth Model. It breaks down each stage to provide a pathway and focus for key strategies and action. These can help optimize performance, outcomes, and revenue at each stage of care management program growth.
The following provides links to each article as they are published for quick reference.
Stage 3: Scalable
Stage 4: Advanced
Stage 5: Optimized
Stage 2: Laying the foundation
Providers and third-party care management agencies launch new programs to improve outcomes, reduce costs, and achieve enhanced performance.
However, knowing how to lay the best foundation is key to avoiding the most common challenges to early-stage programs.
We utilize our Care Management Growth Model as a framework to reveal those challenges and demonstrate how, either through DIY approaches or by partnering with ThoroughCare, new programs can gain traction, be implemented more quickly, and scale volume and reach.
Common challenges and recommended priorities
As shown in Figure 1, we’ve helped clients progress through five stages as they develop, scale, and optimize their care management programs. Progressing through the stages enables organizations to support more patients in managing chronic illnesses and achieving improved health outcomes.
Figure 1: “Laying the Foundation” is the first article in the Care Management Growth Series, covering the first two stages of ThoroughCare’s Growth Model.
The first two stages—early stage and constrained stage—typically present common challenges. These can lead to launch failure, slow implementation, and expansion delays, as well as dampen the program’s ability to grow and scale.
The types of difficulties faced tend to fall into four categories, including:
Workflow: Operational and clinical efficiency
Enrollment: Patient engagement and retention
Compliance: Billing and documentation compliance
Tools and techniques: Technology and skill proficiency
Figure 2 outlines the common challenges faced and our recommended priorities. This is where new care management programs should focus in the initial weeks and months.
Figure 2: Care management operational areas with common early-stage challenges and ThoroughCare recommendations for initial tasks to complete.
Should you start a care management program yourself or partner with ThoroughCare?
It’s a tall order to ask staff and the care team to create all the needed policies, plans, and tools, as well as set up full operations to start delivering care management services to patients.
If your organization has the staff, time, and skills to manage this, then you have a chance of achieving success through a DIY approach. However, the vast majority do not.
Figure 3 highlights the six areas where an organization or team would need to strategize, plan, create, and implement to establish an effective program.
Figure 3: Care management areas that new programs must create and establish successfully.
The benefits of creating and establishing a care management program with only internal resources and guidance often do not outweigh the costs, including:
- Slower implementation
- Risk of denials and CMS audits
- Increased cost in staff time
- Opportunity cost of lost revenue
- Decreased patient retention
- Poor outcomes and performance metrics
However, partnering with ThoroughCare offers numerous benefits as a web-based care management partner and clinical, operational, and technical advisors.
How partnering with ThoroughCare accelerates success
While going the DIY route or trying to use an EHR as a care management solution can seem prudent on paper, in reality, most organizations that approach ThoroughCare have attempted this at significant cost, frustration, and wasted time.
Alternatively, working with ThoroughCare offers the full depth and breadth of technology, education, and support to implement and scale a host of care management programs, including:
- Chronic Care Management
- Principal Care Management
- Remote Patient Monitoring
- Behavioral Health Integration
- Transitional Care Management
- Annual Wellness Visits
- Advance Care Planning
Here are five ways that ThoroughCare can help a new program launch and onboard quickly, avoid and mitigate issues, and scale while skipping growth phases.
1. Best-in-class care management software
ThoroughCare provides streamlined tools and capabilities to engage patients, manage workflow, and simplify care delivery. Our platform supports performance tracking and reporting progress. It interoperates and integrates with the top EHRs, maximizing their value for care management.
2. Comprehensive onboarding
In addition to guidance from a client success manager and the support team, ThoroughCare provides all the necessary tools and education to onboard a new care management program. This includes an overview of the program, eligible conditions, billing requirements, and CPT codes.
Our Clinical Advisory Team helps providers assess their care management challenges and implement solutions, including:
- Tailored workflows to each provider organization’s needs
- Documentation compliance and reporting best practices
- Patient engagement tools and techniques
3. Tailored expert training
Beyond onboarding, our Advisory Team can deliver engaging education to build care management skills, such as motivational interviewing, goal-setting, and self-management coaching. Or, we can focus on a host of topics that relate to all aspects of care management, including:
- ThoroughCare platform mastery
- Program performance tracking, analysis, and reporting
- Enhanced compliance through better billing and documentation practices
- Maximizing patient engagement, communication, and touchpoints
4. Performance metrics mastery
We help new programs develop best practices for performance reporting and outcomes assessment. Then, we help you optimize analytics, complete quality checks, and evaluate program effectiveness.
5. Technology customizations and integrations
Some clients want to tailor the platform further to meet specific clinical directives and assessments, as well as performance metric monitoring needs and reporting requirements. Additionally, we support robust integrations and interoperability with the most widely used EHRs and Remote Patient Monitoring devices.
The journey doesn’t stop with onboarding and the early stages. ThoroughCare walks alongside clients to help them achieve greater scale and impact.
Ongoing support achieves greater efficiency and ROI
ThoroughCare offers support to optimize workflows and scale care management, enabling organizations to reach more patients, become more efficient, and achieve a greater ROI, as shown in Figure 4.
Our Opportunity Analysis helps providers evaluate their current workflow efficiency, patient engagement quality, and compliance practices. Hand-in-hand with our Clinical Advisory Team, we help you improve your program’s operations. Our Opportunity Analysis provides healthcare providers with a playbook to achieve significant ROI, better outcomes, and growing revenues.
Based on this assessment, the team can highlight key issues and solutions, recommending strategic next steps that may include:
- Updating policies and standards
- Implementing new tools or platform features
- Adopting AI capabilities
- Establishing a structured patient engagement framework
- Training care managers on best practices, skills, and competencies
- Utilizing automated KPI tracking, billing best practices
- Optimizing accurate time tracking and documentation
Figure 4: How ThoroughCare uniquely optimizes care management through next-gen technology, services, best practices, and support.
Enabling early success for care management programs
Whether an organization is starting its first, second, or third care management program, ThoroughCare has established itself as a comprehensive technology, advisory, and training partner.
Everything that a new program needs to be successful can be found here.
