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Effectively running a CCM program at scale is a huge undertaking. Attempting to operate everything in-house presents major challenges in terms of staffing, building systems and managing the volume of tasks associated with large patient loads.
On the other hand, hesitancy toward 100-percent outsourcing is a valid concern. Outsourcing can work effectively in this manner but clinics can also benefit from working with a partner on a mixed model to maximize patient reach, control, and resourcing across the internal and external teams.
Read a thorough comparison of outsourced CCM services vs. internal.
Implementing Chronic Care Management: Outsource + In-house
Implementing a mixed model doesn’t necessarily require a complex arrangement. The overarching goal is to serve a broad scope of the patient population while tracking and caring for the most vulnerable patients. Here are a few broad questions to ask when modeling a contractor + in-house chronic care management program.
- Can clinic and contractor systems integrate?
- Who will manage the internal CCM program?
- What are the systems for onboarding and reporting?
- How is communication handled?
- Is the relationship fluid and flexible?
Resourcing internally is much easier with a contractor relationship that integrates and functions within the existing clinical framework. The value is delivered immediately but the clinic retains full control to maneuver and manage patients’ priorities while using the contractor to onboard new patients and manage time-consuming workloads across some or all of the caseload.
Working as a team requires excellent communication and a system designed to alleviate the burdens carried by nurses and staff throughout the clinic. Predefined roles for onboarding, reporting, and management ensure everyone is working together and moving through tasks efficiently.
Flexibility is another major requirement as the contractor will need to adjust and adapt to variables in the workflow. Finding outsourcing partners that don’t require long contracts and rigid parameters is an absolute necessity in the mixed model.
The Risk Stratification Advantage
Complete outsourcing is a concern for nurses because they fear losing control over vulnerable patient populations. H3C has developed a framework to support nurses so they have more time for the patients requiring immediate and frequent attention.
Combining resources makes this process especially fluid by filtering patients according to a risk scale. The high-risk patients move into the hands-on category where nurses are needed most while H3C communicates with patients in lower-risk categories, moving them to nurse-based tasks if their risk level elevates.
In this system, the clinical staff is hyper-focused on patients requiring high-level care while the contractor ensures all enrolled patients are receiving calls monthly. They are listening to patient needs, refilling their prescriptions, and making them feel like a priority.
As a result, the clinic is empowered to deliver higher-level care while reaching across the entire spectrum of patients. The productivity and hands-on team approach also generates more revenue through the FQHC CCM program.
Utilizing New CCM Program Revenue
Outsourcing properly equates to new revenue flowing back into the clinic. Some of that revenue can work toward developing dedicated internal CCM resources that ensure a small segment of staff is focused on communications, onboarding, and delegating caseloads between the clinic and contractor.
When clinics bring everything in-house, the staff requirements are considerable and wait times to develop resources and processes are significant. Through a team effort, the clinical investment is minimal and financially resourced by contractor-developed revenue. Getting off the ground is quick and every party benefits. More importantly, the patients needing care and hands-on CCM are positively impacted.
How Will You Implement Chronic Care Management Services in Your FQHC?
After you’ve asked the hard questions and looked deeply at your existing framework, it’s time to find and implement the best-fit solution. A robust CCM program will reach patients, making them feel good about the proactive approach and high level of care. CCM partners should:
- Support patients between visits
- Provide relief for clinical staff
- Work inside your ERM
- Drive revenue to the clinic
- Integrate naturally with the clinic and existing workflows
- Act as a true partner
How Can H3C Help You in Implementing a CCM Program?
H3C is a dedicated partner with custom solutions and flexibility that maximize output, quality of care, and revenue to the clinic. This nimble approach to CCM programs allows the clinic to increase or decrease caseload output while H3C manages the difference. No start-up costs or long-term contracts lock the clinic into strict parameters. H3C earns trusted partnership status through everyday performance. Learn more about our process.
CCM is a preventative service, helping at-risk patients take a proactive approach to their health and wellness, while keeping them connected to their provider. Through a CCM program, patients work with your clinic to manage their chronic illness in a more consistent way.
Yes it can. For many physicians who do not have the professional staff bandwidth to provide continuing chronic care management, outsourcing solves the time-consuming CCM problem.
In short, yes. Click here to see how much you can earn depending on the number of your patients.
