By Tom Ballard, Chief Alliance Officer, PYA
Here’s a startling statistic for you: only 11 percent of individuals covered by Medicare Part B have ever received a wellness test and yet these are patients in the older, higher risk category.
How do you get those participation levels up to 75 or 80 percent so that individuals can enjoy healthier lives while also reducing skyrocketing healthcare costs? Hospitals and providers are increasingly turning to eDoc4U, a Nashville company founded 15 years ago with a focus on population health management.
In essence, eDoc4U is an outsourced service that providers can offer without adding more staff and management burden to their operation. It also allows the physicians and other medical staff to use their time to deliver patient care while, at the same time, being able to secure continually updated information on their patients so they quickly identify gaps in care.
“We are an extension of their day-to-day staff,” Chad Blackburn, Senior Vice President for Business Development, said. “We are paid for performance.”
Utilizing state-of-the-art tools and proven programmatic approaches to engaging patients, eDoc4U can offer its wellness program for about one-half the cost of an annual visit.
“Medicare Part B is our growth vector,” Blackburn says, “We schedule patients like a campaign.” At 20 visits a day, that’s roughly 400 a month.
The company’s newest product, focused on hospitals and providers, was developed when the U.S. Centers for Medicare and Medicaid Services (CMS) created new billing codes that would take advantage of an innovation award eDoc4U had won from Allscripts Healthcare Solutions, Inc. a couple of years prior to the CMS announcement.
After facing challenges with market adoption, Blackburn says eDoc4U made several strategic changes to the team and “how we sell it.” Two of those modifications involved adopting performance-based pricing and adding nurses to its team. The results have been positive.
“We’re all over the country, but with a lot of the population in Florida,” Blackburn explained.
eDoc4U assesses and reports patient health risks based on the provider’s electronic health record and self-reported data, creates personalized health programs, delivers evidence-based analysis at point-of-care, identifies care gaps, and facilitates outreach. Patients are engaged and empowered to help manage their health, while increasing payer-friendly revenues, enhancing clinical productivity, automating the Medicare Annual Wellness Visit and supporting Chronic Care Management. The company’s offerings include Care Management and Personal Health Manager Services.
“Even though most providers want to offer wellness programs, they don’t have enough time to run them at the enterprise level,” Blackburn says. “It takes a provider with a deep understanding of the business. It’s actually a business within a business. It is possible to run these programs at scale.”
What’s the ideal client for eDoc4U? Blackburn says it is an organization that has a large Medicare population and a strong relationship with its patients including frequent contact. Two groups that meet that criteria are primary care practices and dialysis clinics.
The company also launched a complementary product in 2015 for chronic care management. “The two go together like hand and glove,” Blackburn explained. As noted above, one benefit of the wellness program is the identification of gaps in care which can become action items for a Chronic Care Management Counselor.”
“Clients can choose one or both, but we recommend both,” Blackburn says.