Primary Care House Calls (PCHC) is a 13 provider practice in Northwest Florida. They’ve made it their mission to provide excellent care to patients with a unique set of difficulties – those unable to leave their homes, those who have recently left the hospital, and those who have general challenges getting to a doctor’s office. Since PCHC’s inception, patient-centered care has been their top priority.
Unfortunately, PCHC has learned that a noble mission and excellent patient care are not always enough to maintain financial stability. As it became harder to make ends meet, PCHC knew that a change was in order.
In January 2020, PCHC decided to apply for Primary Care First – a new CMS Alternative Payment Model.
How PCF Could Help
At the core of PCF is a simple idea: when patients receive comprehensive primary care, they are likely to have better outcomes, and their healthcare costs will be lower in the future. For this reason, PCF rewards care providers that provide excellent primary care to their patients.
The best way for a practice to succeed in Primary Care First is to perform Annual Wellness Visits for eligible patients. The Annual Wellness Visit is a tool that helps providers gain a better understanding of a patient’s health outlook and potential risks. When a care provider performs an Annual Wellness Visit, CMS attributes the patient to the practice. The practice and their care team is now responsible for proactively taking care of the patient’s primary care needs.
So, Annual Wellness Visits lead to better care for patients and patient attribution for the care provider and practice. Attribution, in turn, leads to increased payments through PCF.
If a care provider can increase patient attribution, they can increase APM payments, which increases profitability, allowing them to further invest in their patients and their team.
From the outside, it looks like a simple formula: complete Annual Wellness Visits to increase patient attribution, provide better care, lower costs, and raise payments.
In reality – and in busy practices like PCHC – the formula is not always so straightforward.
A New Set of Challenges
PCHC realized that they had to increase the amount of Annual Wellness Visits they performed if they were going to succeed in PCF. But increasing Annual Wellness Visits brought about its own unique set of challenges:
- How do you know which patients are eligible for Annual Wellness Visits?
- How do you keep track of completed Annual Wellness Visits?
- How do you contact eligible patients to schedule the visit?
- What do you do to ensure that AWV get completed fully and efficiently?
- And, as you increase the amount of AWVs you are performing, how do you keep track of billing for those visits?
For PCHC, the additional work required to succeed in Primary Care First would be more than they could handle. Tracking patient eligibility, contacting eligible patients, performing Annual Wellness Visits, and billing for those visits was enough work to cause serious concern for Primary Care House Calls.
With limited patient attribution at the beginning of the program, and a tough road ahead to increase attribution, it looked as if the financial struggles would continue.
But within a year, PCHC was performing Annual Wellness Visits with ease, attribution was soaring, and payments were increasing.
How did PCHC make such a drastic change?
Enter Check – the tool that made success simple.
When PCHC partnered with Mingle Health, they gained access to Check – our preventative medicine platform designed to streamline all the tools necessary to succeed in Primary Care First.
Using Check, PCHC was able to:
- Quickly check patient eligibility for AWVs with our real-time API
- Create an outreach plan to contact eligible patients
- Perform Annual Wellness Visits with less hassle
- Track their patient engagement
- Easily bill for wellness visits
Check packages all these capabilities inside one cloud-based software package that runs on any computer or tablet. With Check streamlining their work, PCHC’s providers could perform services with increased efficiency and effectiveness. As the number of Annual Wellness Visits increased, attribution and payments increased as well.
Over time, it became clear that Check – along with support from Mingle Health – was a critical factor in PCHC’s success in PCF.
The Results – Better Outcomes, Improved Profitability
So how did the outlook change for Primary Care House Calls after they started using Check and partnering with Mingle Health?
With a better understanding of who needed an Annual Wellness Visit and a streamlined method for performing those Annual Wellness Visits, PCHC increased patient attribution by 97%.
And as attribution went up, payments went up. PCHC’s population-based payment increased by $588,00 annually. PCHC estimates that revenue over the next year will reach $1.3 million.
And, best of all, PCHC’s patients are now receiving even better care, and providers have a clearer understanding of patient needs and risks.
Instead of worrying about finances and searching for ways to increase attribution, Check allows PCHC to focus on the one thing that matters: providing excellent care to their patients.
A Partnership for your Success
Do you want to know how Mingle Health can help your team save time, improve outcomes, and maximize savings? Get in touch with us today.
Our Primary Care First success guide for 2022 is available today. In this webinar, Roxane Thacker, VP of Managed Clinical Services here at Mingle Health, provides an overview of what it takes to prepare and be successful in the program in 2022.