Care management provides the best opportunity to offer Advance Care Planning.

UPDATE (1/8/2025): In its 2025 Final Rule, CMS changed the rules pertaining to HCPCS code G0511. Read here for the latest information. Since Medicare introduced care management programs in 2015, coverage has evolved to provide expanded opportunities for Rural Health Clinics and Federally Qualified Health Centers. Historically, however, new care management programs have been launched without initially including RHCs and FQHCs or with significant restrictions.

Advance Care Planning (ACP) is a highly impactful service to add to a provider’s practice. However, confusion around who can deliver and bill these services keeps healthcare organizations from fully embracing and adopting the offering.

Due to the pandemic, the demand for expanded Behavioral Health services in primary care settings has increased significantly. It is reported that one in five adults have a diagnosable mental health disorder, whereas two out of five individuals experience symptoms of anxiety and depression.

As you may be aware, an Annual Wellness Visit (AWV) is a yearly evaluation of a patient's current health. For Medicare Part B beneficiaries, the appointment is free of cost. During an AWV, a doctor will review the patient's health history, identify any potential health issues, and answer any questions. The main goal of an Annual Wellness Visit is to establish a record of the individual's physical and mental well-being to develop a preventive health plan. While Annual Wellness Visits (AWVs) can benefit healthcare providers by improving communication with their patients and helping them collect reimbursements, there are also several advantages for patients themselves.

ThoroughCare has earned NCQA Population Health Management Prevalidation in the following categories: Health Plan, Managed Behavioral Healthcare Organization, Case Management, and Population Health. This means that our platform has the functionality to help other organizations receive NCQA accreditation in the same areas.

What does it take to create an effective and profitable Remote Patient Monitoring program?

Since 2016, Medicare has reimbursed physicians for Advance Care Planning (ACP) counseling. Yet, despite studies indicating that most patients would rather die at home than in a hospital or nursing home, more than 25% do not die in their location of choice.