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2021 Care Management Software
Buyers Guide

All The Tools You Need to Purchase with Confidence

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Maximize Revenue and Improve Health Outcomes

For healthcare providers to effectively manage care coordination and wellness programs, intuitive care management software is strongly recommended.

Care management can provide tremendous benefits to both providers and patients if done well.

We’ll answer all the questions you may have about care management software, equipping you with the knowledge needed to select the best software for your practice.

In this buyer's guide, we'll address the following topics:

  • The top 5 benefits of care management software
  • The 8 key features to look for in quality care management software
  • How to develop decision-making criteria and what's the best criteria to use
  • An in-depth look at ThoroughCare's care management software solution

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Want to print it?

Fill out the form to download your exclusive copy of our buyer's guide to take offline.

or continue reading below!
care_management_software_buyers_guide_final updated

 

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5 Benefits of Care Management Software

A poorly managed healthcare practice can be harmful to patient care and accrue substantial expenses for the provider. Intuitive care management software can prevent these potential issues by improving health outcomes for patients and producing sizable revenue streams for the provider.

Here, we will explore the top 5 benefits of care management software.

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1. Consolidation of Patient Information

Although most healthcare providers have digitized their patient records, that doesn’t necessarily mean their patient information is organized.

Care management software alleviates disorganization by consolidating patient information for every care coordination program all in one place. Both staff and patients will feel more comfortable when healthcare practices are well organized, resulting in better delivery of care.

What should you avoid?

Watch for software solutions with clunky navigation, making it difficult to find the information you need.

You’ll want to look for a smooth workflow that includes patient creation, enrollment, care plan creation, and billing.

Comprehensive Patient Care

2. Increased Patient Engagement

When care management software is built around a patient-centered care model, patient engagement increases dramatically.

This model can be used to simply improve the health and quality of patients, or tie care plans to Medicare reimbursement programs like Chronic Care Management, Remote Patient Monitoring, Annual Wellness Visits, Behavioral Health Integration, and Transitional Care Management.

The patient-centered care model gives the patient and care team the information they need to take an active role in improving patient health. Sharing information on clinical status and progress can go a long way towards easing patient fears and earning their trust.

When patients feel they can trust their doctor, it becomes easier for the patient to become actively engaged in their health. Look for care management software that utilizes the patient-centered care approach.

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3. Improved Efficiency

Managing care coordination programs manually can take up substantial staff time. With care managers managing up to 150 patients (and sometimes more) in any given month, costs can skyrocket.

Care management software drastically reduces the time spent managing patient care by automating many processes for you. With intuitive care management software, you’ll minimize the time spent managing patient records/charts.

Some software solutions may have guided-interview care plans, walking care managers step-by-step through the development of a patient care plan.

When it comes to billing, partially automated billing and claims features can limit time spent on billing and help ensure accuracy in your claims, protecting you against potential audits.

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4. Improved Care Coordination

Care management involves strong coordination between the physician, the care manager, and the patient. This communication can easily breakdown, impacting patient health, and increasing costs for the provider.

Intuitive care management software helps practices coordinate care seamlessly with care plan creation, reporting, and flagging tools. These tools allow all parties involved in a patient’s care to access and share information, ensuring continuity of care.

When providers can offer strong coordination of care, patients are more likely to become engaged with their health.

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5. Improved Accuracy

Having good documentation of your claims and billing, as well as the care you provide to patients is vital to stay compliant with the Centers for Medicare and Medicaid Services (CMS) should you be audited. Auditing of your care management programs may not happen often, if at all, but it’s still something you should be adequately prepared for.

Having a care coordination software that automates much of the documentation and time logging required, and offers intuitive reporting features, can help ease the audit process. Common items looked for during an audit include patient eligibility and enrollment, time logging/proper billing, and documentation of care.

In looking for a care management software that will help in those areas, look for features like automatic billing code assigning, easy report generation, and record keeping.

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8 Key Features of Care Management Software

Now that you know the benefits quality care management software can provide, it’s time to shop around for the best software solution for your practice.

Shopping for care management software can be time-consuming and stressful.

There are many care management software solutions available on the market, making it difficult to narrow down your options. These software solutions range in both price and features, making the buying decision all the more difficult.

Many providers aren’t even sure what they should be looking for. You may be asking yourself what features are most important?

Having worked with over 400 providers across the country, we have seen that while all software differs, there are specific key features present in all good software.

It’s important to recognize that staff within your practice may have different views about which features are most important. For example, what’s important to administrative staff may differ from what’s important to care managers, and further what’s important to physicians.

In choosing the best care management software,  look for a solution that has features that appease most of, if not your entire staff at the practice.

1) User-Friendly Interface

One of the most obvious, but also important features of good care management software is its user interface. You should look for a user-interface that is clean and easy to use, with seamless navigation.

You want your care management information to be easily accessible with the ability to add updates across your patient population. All patient and program data that you need to manage should be at your fingertips.

 

3) Electronic Claims/Billing

Submitting claims and billing for the programs you are managing is vital to the success of those programs. Intuitive software should feature an easy-to-use billing interface that makes claim submission simple and easy.

Good software should take the guesswork out of claim submission, giving you everything you need such as CPT and ICD10 codes to correctly drop claims.

 

5) Customer Support

One feature that can really make a care management software stand out from the rest is the quality of their customer support. Software solutions that provide tech support via email, phone, and/or within the software itself are recommended. Also, look for companies that offer extensive and personalized training on their software. The best software solutions even give providers access to clinical and expert knowledge on care management programs that can help your practice meet CMS requirements.

 

7) Scheduling Tools

Since care managers will be managing the health of dozens of patients each month, you’ll want software that allows them to log, track, and schedule calls and follow-up appointments.

Without proper scheduling tools, the jobs of care managers can quickly become a burden, ultimately translating to worse patient care. All patients should get the care they need and deserve, and this is a great way to make sure no patient gets left behind.

2) Integrated EHR

Care management software can either integrate directly with EHRs or work harmoniously with EHRs as a supplemental solution, or a combination of the two. The important feature to look for is an easy, seamless sharing of patient data between the two platforms.

 

 

 

4) Reporting

Extensive reporting features will keep your practice organized, efficient, and compliant with rules and regulations from CMS. Specifically, look for the ability to generate exportable reports of your patient population, care plan update reports, and monthly billing reports, just to name a few.

 

 

6) Patient Portal

Having a patient portal built into care management software will improve the quality of care you provide for your patients. The portal should give your patients access to reports and summaries of their care, see device readings, alerts, and notifications, and allow for open communication with the care team.

 

 

 

8) Secure Access

Because you are dealing with sensitive, HIPAA-protected patient information, you’ll want secure software. Good care management software should allow for secure access wherever you are via desktop, tablet, and/or smartphone.

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Annual Wellness Visit

These Medicare wellness visits are offered free of charge to your patients each year. Unfortunately, many providers skip this because they are too confusing. Get the clarity you need by visiting our AWV page. 

Visit AWV Page

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How to Choose the Best Care Management Software

Now you know the benefits of quality care management software and you know what features to look for when shopping. How do you condense all that information and make the right buying decision?

Below we'll guide you through the steps to take when making that decision and provide a set of criteria to evaluate your care management software options against. 

Step 1: Establish Goals

You first want to establish goals for your care management programs. All decisions you make regarding your care coordination and wellness programs should ultimately serve these goals.

Step 2: View Tools and Features

Identify software with the tools necessary to best accomplish your goals. Browse the website of software you are interested in to see if the software fits your needs.

Important note: Staff within your practice may have different views about which features are most important. For example, what’s important to administrative staff may differ from what’s important to care managers, and further what’s important to physicians.

Look for a solution that has tools and features that appease most of, if not your entire staff at the practice.

Step 3: Try a Demo

Give the software a try.

Seeing the software in action can be telling if the solution will work for your practice.

Step 4: Evaluate Against Decision-Making Criteria

Evaluate each software solution against a set of criteria. While no two providers share the same criteria,

we’ll explore the most common and important criteria providers use in evaluating care management software.

Criteria


Pricing:

Pricing of care management software can vary widely depending on the number of programs and patients you’ll be managing, as well as the features included in the software.

You’ll find software priced as low as $.99 to as high as $8 per patient per month. Full-service solutions can cost as much as $20-$30 per patient per month.

Ultimately, the old adage of “you get what you pay for” rings true. You may find low-cost software solutions that require more manual use and little-to-no automation, requiring more staff time to use. Low-cost software may also lack extensive reporting and auditing functions, and come with poor technical support.

Premium care management software will have most, if not all of the features and functionality we covered earlier in this guide. Though premium products will cost your practice slightly more, the returns on investment for those software solutions are usually substantially higher than lower-cost options.

Look for software vendors that have transparent pricing, including tools such as ROI or pricing calculators that show you potential costs and/or return on investment.

Reporting

Look for extensive reporting features like the ability to generate comprehensive and exportable reports of the following items:

  • Time logs

  • Enrollment information

  • Claims and billing information

  • Care plan summaries

  • Call log summaries

  • Care Manager activity

You should easily be able to see all of your clinical data, summaries, and activities in PDF or CSV formats.

Reporting allows providers to measure the effectiveness of the programs they’re managing and leverage the data to learn, adapt, and improve their programs.

Reporting can also be beneficial in case of an audit by CMS. By knowing the proper billing requirements for each program, developing a coherent workflow, and utilizing software that makes it easy to generate the reports and documentation needed, you’ll save yourself a lot of the hassle that usually comes with an audit.

Extensive reporting can also improve quality scores for MIPS and MACRA through the measurable quality improvement of patient care. These are quality measures that CMS uses to reward practices in the form of higher reimbursements based on the quality of care they provide.

Compliance & Security

Your care management software should be HIPAA compliant. There are certain legal and regulatory requirements defined by HIPAA that you’ll want to ensure the software meets. Ask about the HIPAA certification.

Is there a contingency plan? Data backup plan or data recovery plan? For example, some software solutions will work with 3rd party vendors to backup their data.

If this is a platform that you’re going to access and export patient information in, you need to make sure the security that the software solution you’re providing isn’t leaked or ever at-risk. If information is compromised you open yourself up to legal repercussions.

Additionally, look for security policies within the vendor or through third parties to manage information, monitor activity, and authentication processes to keep your protected health information safe and secure.

Ease of Use

Most care management software vendors claim that their solution is easy to use. So how do you know if it’s actually true? Try a live demo of the software.

During the demo, you’ll want to have the staff that will be using the software present so they can see the software in action. Specifically, pay attention to the general layout of the user interface, the look and feel of navigation, and the features that cater to all users from administrative staff to physicians.

Some software solutions also offer extensive customization options. While customization is normally thought of as a positive attribute, be careful about the software becoming too complex. The purpose of intuitive care management software is to improve efficiencies and make managing these programs easier, not harder.

Intuitive software will usually meet the needs of even the largest providers without the need for customization.

Clinical Content

CMS requires care plans for most care management programs.
A comprehensive care plan for all health issues typically includes, but is not limited
to, the following elements:

  • Problem list

  • Expected outcome and prognosis

  • Measurable treatment goals

  • Symptom management

  • Planned interventions and identification of the individuals responsible for each intervention

  • Medication management

  • Community/social services ordered

  • Schedule for periodic review and, when applicable, revision of the care plan

As mentioned earlier, lower-cost solutions may still require you to manually input most patient information. With care plans, quality software solutions offer simple templates that care managers easily populate themselves.

The best care management software will use a guided-interview approach to care plans. This approach walks the care manager through the entire care plan step-by-step. The software will have clinical content and questions built-in, doing most of the leg work for the care manager.

Integration Ability

The best care management software solution is meant to be used with any certified EHR.

That can either be through direct integration with your EHR or as a supplemental solution to your EHR that allows for seamless sharing of data across platforms for items such as care management reports and summaries.

This is useful because many clinicians won’t access a patient’s information on the software itself. Instead, they’ll rely on reports and summaries to see patient data and care info.

Some EHRs do allow care management solutions to directly integrate with them. This is because EHRs generally don’t support care management very well. Direct integration with EHRs allows for seamless instantaneous sharing of data without the need to download or upload, limiting the time spent in the EHR.

Some EHRs do offer their care management software solution, but they’re limited in functionality and features, resulting in more staff time, fewer audit features (opening yourself up to audits), and worse coordination of care (less patient-centered care).

This feature improves efficiency and ensures accuracy in data between your EHR and care management software.

Support & Training

When purchasing a care management software solution, you should consider it as entering into a relationship with the vendor.

A relationship thrives when your partner supports you and you should look for a strong support system when shopping for care management software.

You will want to know if the vendor will work with you to onboard your team. Some questions to ask include:

  • Will they supply training?

  • Is that an extra cost or included?

  • Does the software have ongoing technical support after onboarding?

  • Do they have a library of educational content and helpful articles?

The best care management software will include onboarding and training for your staff, live technical support via phone, email, and instant messaging, and a large library of educational content and resources.

“Our experience with ThoroughCare has been absolutely wonderful. They provide superior customer service. Since starting the Chronic Care Management program through their platform, we have made many positive impacts. We have increased our quality measure scores and reduced hospital readmits, resulting in a decrease in overall spend. Our providers are much more engaged with their patients' care team.”

Sabrina Martin, Director of Provider Network Management - National ACO

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Inside Thoroughcare's Software

We understand that purchasing care management software is a big decision. That is why we firmly believe in transparency and working with you, guiding you through the buying process to make it as easy and stress-free as possible.

We’ve worked with over 400 healthcare providers across the country, providing them with the tools necessary to maximize health outcomes for their patients and revenue streams for their practice.

Our workflows were developed by real-life doctors and clinicians to ensure that our software fits naturally into the way Care Management programs actually work.

While clinicians were consulted for workflow development, our team of healthcare entrepreneurs and developers built software that is both clinician-friendly and easy to use.

ThoroughCare provides a HIPA A-compliant and cloud-based platform to assist providers in the management of Medicare patients for care coordination. Through simple and intuitive tools, you’ll be able to effectively manage and automate your care management workflow.

1. HIPAA-Compliant Software

Your practice will get access to your own, HIPAA- compliant software portal, giving you peace of mind that patient and practice data is safe and secure.

 

2. Care Plan Reports

Create extensive care plan reports for patients and providers that can easily be exported to your EHR chart, patient portal, or other providers for coordinated care.

 

3. Data Reporting

Export patient and user data via reports for both individuals and entire populations with our elastic reporting capabilities. Provides measurable statistics and audit support with PDF and CSV reports.

 

4. Unlimited Users & Patients

Built for practices large and small, our software has no limits on the number of users or patients you’d like to manage. Admin privileges allow your practice to stay organized and efficient.

 

5. Tech Support

Get access to tech support via email, phone,
and instant messaging within your site. Our dedicated support team happily offers help with
implementation and provides continuous training opportunities.

 

6. Easy Billing Interface

Our billing interface helps assign the proper ICD-10 and CPT Codes and helps generate the Medicare claim submission, easing the burden on your billing team.

 

7. Call Scheduler

An interactive calendar allows you to schedule patient calls and provides an audit trail to ensure continuity of care for your patient population.

 

8. Customer Dashboard

Intuitive interface with seamless navigation gives you easy access to all programs and patient data. Your live dashboard will show non-face-to-face care updates in real time.

 

9. Task Tracker

Our task tracker includes a timer for easy time logging as you complete care for the various programs you’re managing.

 

10. Guided Care Plans

Our guided-interview process automates the patient- centered care plan for you, taking the guesswork out of it.

Get 50% off your first month

When you schedule a live demo. Since your time is valuable, we're offering a 50% discount off your first month's program fees. At the end of the demo, you'll receive a customized price quote!

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