The CAPC Payment Accelerator: A Joint Virtual Workshop for Home-Based Care Teams-CAPC Live Chat

CAPC Live Chat
Pdf Summary
The summarized document provides an extensive discussion on various aspects of home-based care, focusing on questions and insights from a live chat among professionals.<br /><br /><strong>Value of Home-Based Care:</strong><br />- Data from HCCI and CAPC underscore the financial and patient support benefits of home-based care. For skeptical stakeholders, it’s suggested to propose achieving just one-third of the benefits highlighted in studies as still valuable.<br /><br /><strong>Panel Size and Staffing:</strong><br />- Concerns about capitated payments reducing visit frequency are raised. Stratified panels adjusting visit frequencies based on patient stability are recommended.<br />- Financial accommodations using Chronic Care Management (CCM) and other billing codes are discussed.<br /><br /><strong>Team Models:</strong><br />- Co-management models in partnership with PCPs are preferred. Challenges of different contract types on clinical models and billing practices are elaborated.<br />- Funding challenges for chaplains and alternative funding models are mentioned.<br /><br /><strong>Community Health Workers:</strong><br />- The increasing use of Community Health Workers (CHWs) for home visitation and racial engagement improvements are noted.<br /><br /><strong>Financial Planning:</strong><br />- Details on setting PMPM payments and considerations for patient risk scores, driving density, and program mission affecting contracts are covered.<br /><br /><strong>Social Work/Billing:</strong><br />- Discussions include billing codes for Licensed Clinical Social Workers (LCSWs) and using psychotherapy billing opportunities.<br /><br /><strong>Electronic Health Records (EHRs):</strong><br />- EHR systems such as Athena, AllScripts, and others are evaluated, noting difficulties in finding one perfect solution.<br /><br /><strong>Interdisciplinary Teams (IDTs):</strong><br />- Structures for weekly or biweekly IDT meetings and their efficiencies are explored.<br /><br /><strong>Data Analytics:</strong><br />- Challenges and opportunities of using predictive algorithms in identifying high-risk patients are debated. Integration with systems like Acclivity for patient prognosis prediction is also mentioned.<br /><br /><strong>Referrals and Triage:</strong><br />- Strategies for working with payer partners, handling referrals, and conducting effective patient triage calls are shared. Suggestions include solid care plans and preparing patients and providers for discharge scenarios.<br /><br />Overall, the discussions offer detailed practical insights into improving home-based care, from financial models to patient engagement and interdisciplinary collaboration.
Keywords
Home-Based Care
Financial Benefits
Panel Size
Staffing
Team Models
Community Health Workers
Financial Planning
Social Work Billing
Electronic Health Records
Data Analytics