FAQ: Addressing CCM and RPM Provider Concerns

Chronic diseases like diabetes, cancer, and heart disease have become the leading cause of death in the U.S. Patients with these illnesses need more than an occasional trip to the doctor. They need ongoing, regular care to monitor their illnesses and support them as they follow their prescribed treatment plan.

Chronic care management (CCM) and remote patient monitoring (RPM) offer value-based, patient-centered care that is proven to reduce hospitalizations, ED visits, and achieve better outcomes. As industry interest in these programs has grown, so has the availability of third-party CCM and RPM services. But these services vary widely in what they offer, their effectiveness, and the burden they place on clients.

As a result, many healthcare providers are understandably cautious about implementing these programs. They often voice concerns about cost, reimbursement, compliance, staffing, and complexity. These are important considerations, and having clear answers can help providers make a confident decision that will benefit both the practice and their patients.

Below, we answer some of the most common questions we hear from providers about how CCM and RPM services work.

How much will the programs cost?

There’s no upfront cost for our services or devices, and our pricing model allows you to keep more of your reimbursement dollars. The programs bring in additional revenue streams, boosting overall practice profit.

It's also important to understand that you will not incur any costs typically associated with running CCM or RPM programs in-house. We absorb all the functions associated with providing monthly services including staffing, payroll, and clinician management.

What if my patients don’t engage with the program?

CMS requires a minimum standard of patient engagement to qualify for reimbursement. To meet these compliance requirements, we use a multifaceted outreach approach, including tech-supported behavioral nudging that encourages consistent patient compliance. Nudging, a concept rooted in behavioral science, involves subtle prompts that help patients take positive actions without feeling pressured.

Our approach includes daily app-based reminders, color-coded prompts, texts, and push notifications designed to encourage patients to take their vitals or engage with their care coordinator. Our team also makes consistent monthly phone calls to patients to encourage compliance and monitor adherence with provider established goals.

We consistently maintain high patient compliance rates, ensuring patients benefit from our programs and your practice receives the maximum reimbursement.

Will these programs create more work for my staff?

No, we handle everything! From identifying eligible patients and conducting outreach, to onboarding, monthly service, and billing support, we manage the entire process so your staff doesn’t have to.

Our end-to-end services are designed to reduce your administrative burden, so your team can focus on delivering exceptional in office patient care.

Will my team have to learn any complicated new technology?

Not at all. There’s no new technology for your staff to learn or manage. Our proprietary platform, iCare by HealthXL, integrates seamlessly with your existing EMR workflow, providing your team with real-time access to care and treatment plans.

Behind the scenes, iCare powers every aspect of our CCM and RPM delivery. It guides our care coordinators through standardized workflows, ensures personalized and consistent care for each patient, securely stores PHI, and maintains complete audit trails for compliance.

Are your programs HIPAA compliant?

Yes! We’ve maintained an A+ HIPAA compliance, third-party rating for seven consecutive years. Our internal processes are specifically designed to protect patient data and ensure regulatory compliance. We conduct regular audits and quality reviews across every area of our operations. This includes:

1. Reviewing care and treatment plan documentation, including making sure the latest version is always available in your EMR
2. Evaluating patient and care coordinator phone interactions, for both compliance and quality of care
3. Coaching our care coordinator based on audit results

Our quality assurance team holds every care coordinator to the highest standards and takes immediate corrective action when necessary.

When you partner with HealthXL, you’ll feel confident in the professionalism, compliance, and quality of every interaction.

How to Get Started with CCM and RPM

Adding CCM and RPM programs to your practice can seem overwhelming. At HealthXL, we take the administrative burden off your shoulders and handle every program aspect from enrollment through monthly service, while maintaining strict compliance. Our meticulous approach improves patient outcomes and boosts practice revenue, all without adding to your cost or workload.

Ready to learn more? Contact us to learn how we can partner to develop robust and effective CCM and RPM programs for your practice!