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 />**Value of Home-Based Care:**<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 />**Panel Size and Staffing:**<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 />**Team Models:**<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 />**Community Health Workers:**<br />- The increasing use of Community Health Workers (CHWs) for home visitation and racial engagement improvements are noted.<br /><br />**Financial Planning:**<br />- Details on setting PMPM payments and considerations for patient risk scores, driving density, and program mission affecting contracts are covered.<br /><br />**Social Work/Billing:**<br />- Discussions include billing codes for Licensed Clinical Social Workers (LCSWs) and using psychotherapy billing opportunities.<br /><br />**Electronic Health Records (EHRs):**<br />- EHR systems such as Athena, AllScripts, and others are evaluated, noting difficulties in finding one perfect solution.<br /><br />**Interdisciplinary Teams (IDTs):**<br />- Structures for weekly or biweekly IDT meetings and their efficiencies are explored.<br /><br />**Data Analytics:**<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 />**Referrals and Triage:**<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