Government payers continue to invest in programs that improve equitable access to health care for the medically underserved, geographically isolated, and economically vulnerable.
With the highest slated Chronic Care Management (CCM) reimbursement rate of 2022 committed to FQHC’s and RHC’s, and recent news that HRSA Slots $13M to Expand Rural Behavioral Healthcare Access, government payers continue to assert their support of expanding access to care through remote care delivery.
FQHC/RHC’s are not like other providers, by way of pay structure and patient populations with a high concentration of Medicare and Medicaid patients. Through Care Management programs, FQHC/RHC’s have a unique opportunity to provide significantly higher continuity of care. CMS has enabled FQHC/RHC’s to offer CCM on a much larger scale, saving money, expanding care, and delivering quality.
Backed by knowledge and significant experience, RevUp is a customizable solution for any FQHC/RHC with any budget, specializing in HRSA grants for Remote Patient Monitoring. RPM is an effective way to ensure populations with chronic conditions receive the continual care they require–whether they’re at home or in the clinic. By offering Chronic Care Management and Remote Patient Monitoring together, all integrated within your EHR, RevUp provides Federally Qualified Health Centers and Rural Health Centers with an opportunity to maximize grant dollars for RPM and now, behavioral health services, and fuel revenue through significantly increased Care Management code G0511.
What does this mean for your FQHC or RHC?
Medical practices have been continuously faced with higher cost of delivery and lower reimbursement in Fee for Service. Coupled with the unique challenges faced by FQHC/RHC’s, such as revenue diversification, accessibility to rural and low-income communities and increased competition from new sources (Federally Qualified Health Centers Troubled by Rising Competition), FQHC/RHC administrators face exceptional challenges maintaining their long-term financial viability. Care Management programs like CCM, RPM and AWV have emerged as an excellent opportunity to capture time spent and higher reimbursement with an often underserved, existing patient base.
CMS is incentivizing providers to expand their reach to patients with chronic conditions, economic vulnerabilities and geographical challenges, and rewarding providers furnishing care coordination and virtual care. FQHC’s and RHC’s offering both RPM and CCM services have a unique opportunity to diversify revenue streams, mitigate risk, and provide a complete care management program to their chronically ill patient population.
“Medicare has validated what we have known all along; care management works,” said Paul Huffman, VP of Sales and Business Development at MD Revolution. “As we move forward in 2022 we are excited to expand our services, help more patients, and get connected devices into homes.”
Chronic care management is currently a valuable, revenue-generating service. The actions CMS has taken and continued HRSA grant distribution in 2022 will only further enhance this value.
To learn more about expanded 2022 CMS Care Management reimbursement, download the guide.