Difference between revisions of "E Interventions"

Revision as of 11:04, 7 December 2016

E Interventions are patient interventions that help manage a patient's health care and/or health which:

typically do not receive reimbursement from traditional health insurance
likely will improve patient outcomes and reduce overall cost

These interventions typically don’t qualify for Medicare Part A (hospital), Part B (physician), Part C (Medicare Advantage) or Part D (medications) direct reimbursement. They can be described as Medicare Part E Interventions as there are no Medicare Part E reimbursements or "E - none of the above". Most health plans are based on Medicare fee schedules, so they typically do not provide reimbursement for E Interventions. E Interventions may be delivered exactly the same way as clinical interventions that get reimbursed (like home health), yet they come with stipulations that may not suit the patient's situation. For example, a patient needs to stay 3 nights in a hospital to qualify reimbursement for home health services. If home health services are provided, they may not be reimbursed even if it is what the patient needs to improve their recovery. Another example is a physician speaking on the phone to their patient, which typically do not receive reimbursement for the physicians's time.

The types of "E Interventions" include:

E Intervention Programs - These are team-based patient focused programs designed to meet the specific needs of patients based on a criteria. These programs are integrated with the patient's physician care plan for either a duration or while a patient continues to meet the criteria. The criteria includes risk scores, event, current health conditions and determinants.

E Intervention Programs

New healthcare reimbursement models attribute patients to primary care physicians and healthcare systems for episodes of care. The following Care Management programs are often provided to patients to improve their overall health and healthcare outcomes. These programs include care plan development, administrative support in booking appointments, finding services, coordinating medical services and reminding patients. See which E Intervention Programs work.

Behavioral Health & Primary Care Integration

Screen patient via Primary Care Physician Offices' Clinical Staff
Engage patients to ensure followup with Behavioral Health providers
Collaboration between Primary Care and Behavioral Health to ensure best treatment and patient activation

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 These interventions typically don’t qualify for Medicare Part A (hospital), Part B (physician), Part C (Medicare Advantage) or Part D (medications) direct reimbursement. They can be described as [http://www.health3-0.com/reimbursement/ready-for-medicare-part-e/ '''Medicare Part E Interventions'''] as there are no Medicare Part E reimbursements or "E - none of the above". Most health plans are based on Medicare fee schedules, so they typically do not provide reimbursement for [[E Interventions]]. [[E Interventions]] may be delivered exactly the same way as clinical interventions that get reimbursed (like home health), yet they come with stipulations that may not suit the patient's situation. For example, a patient needs to stay 3 nights in a hospital to qualify reimbursement for home health services. If home health services are provided, they may not be reimbursed even if it is what the patient needs to improve their recovery. Another example is a physician speaking on the phone to their patient, which typically do not receive reimbursement for the physicians's time.
+The types of "E Interventions" include:
+* [[E Intervention Programs]] - These are team-based patient focused programs designed to meet the specific needs of patients based on a criteria. These programs are integrated with the patient's physician care plan for either a duration or while a patient continues to meet the criteria. The criteria includes risk scores, event, current health conditions and determinants.
 ==E Intervention Programs==

Difference between revisions of "E Interventions"

Revision as of 11:04, 7 December 2016

Contents

E Intervention Programs

Behavioral Health & Primary Care Integration

Chronic Care Management

Episode Management

ER Case Management

Exercise & Nutrition

Health Coaching

High Need High Cost

Home Care

Medical Home

Medication Management

Palliative Care

Transitional Care Management

Virtual Care

E Intervention Services

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