RPM, CCM & More Support – Setting Expectations For Success

RPM, CCM & More Support – User Feedback, Q&A, Pharmacist Enrollment, CCM Program, Onboarding

ValueCare Suite | Contact Infos
Ean Shelley: ean@valuecaresuite.com

Transcription:
I’m gonna let some people in But Ian, please go ahead.
Sounds great. So today. I’m not sure how familiar everybody is with the CCM and RPM programs. So we can go over some of the basics of those if you’d like or we can skip over that and go through. What I’d like to talk about today is setting expectations for success. Once you’ve got your physician partnership once your or when you’re speaking with the physician and how to set yourself up so that your program has the best chance for success. It looks like we’ve got I know Tommy, and it looks like we’ve got three more pharmacists here. Have you guys had much experience with CCM or RPM or spoken with us about these programs before?
You know listen to him before but I have not had much experience but I don’t want to hold you up from moving forward.
No worries. So what we’ll do, we’re going to go over some brief overview on just basic concepts. And then we’ll dig into the setting expectations for success. And so these will kind of go hand in hand what I’ll do I’ll go ahead and share my screen right now.
Sorry, just getting all the Zoom stuff out of the way. Cool. So let’s look at this first. Basically, there are two programs. We talked about remote patient monitoring and chronic care management. There are many more programs. Medicare’s actually come up with quite a few of them, and they’ll reimburse the different rates. But the big moneymakers in pharmacy partnerships with physicians are going to be chronic care management and remote patient monitoring. And so these two programs have just kind of got a visualization here. The easiest one to describe to a physician, the one that they get right away is remote patient monitoring. So that’s going to be the quickest, easiest sale when you talk to a physician on how to get that partnership is you say hey, I’ve got a blood pressure monitor that I want to send home with your patient. And that blood pressure monitor is connected to our system. So anytime they take their blood pressure, those readings come into us. And so we’re gonna watch for any alerts or warnings. We’ll set a target for that patient, start training them and start working towards a goal to stabilize their blood pressure. And so we’re going to escalate to you when needed. And we’ll be billing for the time spent looking at all these vitals and speaking with the patient. For 20 minutes of time, we’re gonna get about $50 and for providing the device each month we’re gonna get about $50 And so that’s probably the quickest and easiest way to describe to a physician. What RPM is we can get down in the weeds more and everything like that, but physicians get to that point. Once you say you’re gonna send a blood pressure monitor home with the patient. They get really excited. Now the other program chronic care management is actually far more utilized with pharmacies when doing a physician partnership. However, it’s just harder to grasp the concept immediately. So when we talk about chronic care management, what I like to say is that we are turning non revenue generating activities into revenue generating activities. And what I mean by that is in a physician’s office, you’ve got the revenue generating activities, which are office visits, and that’s basically you know, they can do a flu shot once in a while they’ve got these little activities that generate some revenue. But for the majority of it, in order for a physician’s office to generate revenue, they need to have office visits. And so if they can pack more office visits into a day they make more money. Now, there’s a lot of in between visit care that takes place in a physician’s office, as well as in a pharmacy. So same thing with the pharmacy you fill the prescription. But you talk to the patient in between filling those prescriptions you escalate to physicians when patients have questions. There’s a lot of care and care coordination that takes place that isn’t being captured and isn’t being documented or built. And so basically, what we’re doing with these programs, is documenting all these cares that take place in between office visits, and we’re now able to bill for them. Not only are we able to bill for those activities, but in the office physician’s office, the physician is the only one that really generates revenue. And now we’re able to take additional staff members, you know, like you’ve got your ma your RN nursing staff there in the office. There are times now billable under these programs and to that same effect. When you partner with the physician. You become contracted clinical staff to the office. And so now your time which was non billable for for the physician is now billable. And so essentially every 20 minutes you spend with the patient is another billable activity. And so if we zoom in here a little bit for chronic care management for the first 20 minutes you get about $60 for the second 20 minutes, you get just under 50 and so you can see for 20 minutes $60 for 40 minutes, 100 150 for 60 minutes, and that’s all reimbursed to the physician. So we’re now taking all these activities which were non billable, turning them into revenue. Not only are they revenue but their revenue from non from previously non revenue generating sources. So that physician still has the same amount of office visits. In fact, with these programs, you’re generally increasing the amount of office visits for these patients. Patients are usually seen, you know, three to four times a year, but now they’re being seen five to six times a year you’re catching patient exacerbations before they get too bad, getting them into the office, keeping them out of unneeded emergency room visits unneeded hospitalizations, you’re helping lower these physicians readmissions readmission rates to hospitals. There’s quite a bit of bent there quite a bit of quite a few benefits from these programs, not just the direct revenue. And so when we look at chronic care management that way, you can see how there’s a little more explanation to do to be able to say we’re taking these non revenue generating activities and generating revenue. Now, the main reason why Medicare has these programs is so that they can save money. If they save money, they make money. So essentially if a patient goes to a ER visit, they get they become hospitalized. They had a heart attack, something like that. We’re gonna say about 20 to $25,000 comes out of Medicare’s pocket, and so it’s worth it to them a $60 per month or even $150 per month. Just to make sure that patient doesn’t have as an unneeded ER visit or unneeded emergency room or hospitalization. So if we’re able to keep a patient happy, healthy, keep them stabilized, or if we notice something’s going wrong get them into the doctor’s office earlier so that they can stay out of the hospital because we didn’t catch it. And so that’s what Medicare’s whole goal is, is we want to keep these patients happy, healthy and work that way. So that’s going to be program basics. Now. These programs again are physician billable. So the billing will take place from the physician’s office when you partner with the physician. The pharmacy will become clinical staff to the physician so any anytime you spend anytime your staff spends is billable under the physician as incident two, that means that you don’t have to be under the same roof as the physician. You could be working from the pharmacy if your staff is working from home that day, because they’re out sick with a kid. They’re able to still generate revenue from home calling patients working with patients when they have time, and so you don’t lose all day of work. You’re able to work from home you’re able to work in a remote remote location. And then we’re just escalating to the physician escalating to the office when needed or when there’s an exacerbation with the patient or something that we need to follow up with. And so once you understand that once we’re getting ready to set up with a partnership with a physician, let me show you kind of how this works is you want to set up an agreement that’s called a fee for service or under a fee for service structure. And so with that, if we say hey, we’re getting $62 from Medicare for this code 99490 You’re going to hear a lot of people talking about percentages when partnering with physicians. And that’s all good and well when talking about concepts and understanding how it works, right. So if we get $62 We’re gonna get
70% of that for the work that we perform. And that’s okay for understanding when we sign the agreement. We’re going to set up that fee for service structure, meaning every time we complete this code, we’re going to get X dollars paid to the pharmacy or to our group from the physician and so they’re paying us for our time our work completed. And it’s not a revenue share. It’s not a revenue split, but we’re being paid for the time that we spent working with these patients. And so that’s how you want to structure the agreement. Value cure suite has a template agreement will provide to you that you can use with setting up that you can make any changes you want on there, but you can use it as is and you’re covered. But basically what you do is per billing code, you just come in and say alright, we’re going to charge $43.50 For every time we complete this code 99490 That’s approximately $70 or 70%. Sorry, and we know that the physician would keep about $18.50 After all said and done after paying yes and all that. But yeah, so with this, you’ll set that up for every billing code. And again, we’ll go through that. We can go through that later to how the billing codes are structured, how it goes through the billing. At the end of the month, you generate a billing summary as well as a an invoice for the physician and so setting all this up on your agreement in the software. It all automatically generates at the end of the month. You just tell it which reports to generate and then it’s done. So that’s how the structure will be set up with the physician. We had another webinar before where we talked about approaching a physician. And so I won’t talk about that too much today. But I can send you a link to the diversify webinar that we ran before. So you can watch that or you can jump on a call with me later and we can review that as well one on one but what I wanted to talk about today was setting expectations for success. And so when running these programs, what happens is the hardest part up front is getting that initial physician partnership. And so once we’re close to getting that partnership or getting negotiations with that, or once we’ve gotten that, that’s where we want to make sure that these expectations are all in place, and that you’ve got a plan in action. So that with that partnership, what do you do to roll out this program to be the most successful? The first thing that I want to mention is that you want to dedicate time to these programs, the time that they deserve. And what I mean by that is we’ve got we’ve got a partnership with this physician and they’re willing to give us you know, 500 200 100 patients, however many patients and if we decide well, for our team, we’ve got three staff members in the pharmacy, and we’re all just going to jump in there and tag team at all spend a few hours or a couple hours a day, you’ll spend a couple hours a day and just kind of all jump in there and do our own thing and then be done for the month. That scenario doesn’t really work well. In fact, that’s that’s probably the number one failure for these programs is just not dedicating a specific person to be the manager and to run these programs. It’s okay if you’re the pharmacist, lead pharmacist to take the bull by the horns at the beginning and when you’re getting started to be the main person running this but you do want to make sure that you do want to make sure that you have in mind who you would like to manage and run these programs. We got a question from Rick real quick. Okay, so how do you identify patients within the MDS office? Okay, so we’ll talk about that as part of this ramping up period. So I’ll circle back to this question here in a few minutes. But basically, as we’re planning on rolling out most important is to have that CCM RPM manager staff. They don’t have to be full time, but you need to dedicate somebody that says this is your job. At the end of the month we’re going to be reviewing how many patients we’ve completed. We’re going to be reviewing what is left to do in the month because if you have any patients with time remaining, so this patient has 16 minutes left until they hit that 20 minute increments. But for example, if they had three minutes, five minutes, stuff like that, if you don’t hit that 20 minutes, you don’t get any revenue from it. So you get $0 So you need to hit that minimum 20 minutes. And what happens the reason why physicians outsources so frequently, is because they take that approach of a of an attack team approach, and they don’t have a dedicated person to go through at the end of every month. Make sure that this gets completed and so they leave tons of money on the table from all these incomplete cares. And so that’s what, that’s why the physicians are outsourcing because they just don’t have the time, the structure to make sure that that happens. And so we want to make sure from the pharmacy when we’re partnering with them. That we have that structure in place. And so, again, just emphasizing even if you’re planning on starting at yourself, for the first month, two months, that’s okay. Once we hit about 200 patients or get close to 200 patients, that’s where we’ll want to either take somebody from the pharmacy and say this is now your full time job. This is the only task you’ll be doing in the pharmacy or hiring somebody else. bringing on a new staff member and saying this is going to be your full time job. This program if if this is your full time focus, we’re gonna see massive amounts of success. compared to if you take an employee and say, okay, half your time do this half the time do stuff in the pharmacy, because in the pharmacy, they’ll find distractions they’ll find things to do. And this program will get the time dedicated to it that it deserves. It’s literally a revenue generating program. So every 20 minutes you spend is money in the pocket. I mean, you hired question for you. Yeah. on
that. The amount of time you said 20 Is it a cumulative at all? I thought at one time you meant just mentioned it was a cumulative time that can gather Is that true? In other words, if you do it right, then then you do another for 10 That doesn’t qualify for 20 it has to be 20 minute increments.
No, so you’re correct that it can be cumulative time. And so that’s where it’s really important to have that member that looks at everything at the end of the month. Because let’s say a patient comes in and fills their prescription and then you speak to him for three or four minutes afterwards, just talking about the prescription itself. You know, the patient used to have stomach issues when they took this medication. So you recommend maybe eating it with a heftier meal, maybe some milk, whatever that time that you spend with the patient and after filling it. That’s part of that 20 minutes and so you can put part of that time and another staff member can put more time in and so it’s okay to tag team, the tag team that care provided to the patient. But you do want to have a focus for at least one staff member on making sure that everything’s completed, if that makes sense. So, like you were saying, cumulative, were at the end of the month, if we’ve got five minutes remaining, because we’ve spent 10 minutes here, five minutes there, but we’ve got five minutes to hit that 20 minutes. That’s when that that team members can be really efficient and effective to make sure that we’re hitting our completion rates as we should all right. Thank you. Yeah, and to that point, one staff member full time can take about 200 patients in both rpm and CCM programs. And so their time spent between those programs. That’s about how many patients you want to assign to a staff member. Now, if you’re only working on CCM, you could probably do anywhere from 200 to 300, just depending on how much time they spend with their patients. And so, what we usually recommend is targeting about 200 patients per full time equivalent. So you could have one full time person to part time people and then have 400 or 500 patients. You know, you don’t have to every 200 patients put a full time person on there. But we do need one manager. That’s full time that really focuses on the success of this program. I know I’m harping on that a lot. But when that happens, these programs explode. Yeah, it’s that’s the quickest and easiest way to make sure you have success. And if for 20 minutes of time spent, they’re pulling in $40 Even if you pay him $30 now or you’re still making a profit for only working 20 minutes out of an hour. But yeah, anyway, let’s move on to the next point. So Rick wanted to know how to identify patients in the MDS office and what I’m going to do here is talk about that as well as well, let’s let’s start there. Basically, patients that are on Medicare Part B only. They’re going to have well I guess what we need to talk about first is CCM eligibility sorry. So in order to be eligible for chronic care management, patients need to have two or more chronic conditions, and they need to verbally agree to participate in the program. There are some other requirements and stuff in there but that’s going to be the main focus right so they need to note there’s a there’s a potential for a copay and verbally agree and have two or more physical diagnoses that are chronic. That could be obesity, congestive heart failure, diabetes, arthritis, whatever. The majority of Medicare patients all have that. And so when we look at that, we can tell the physician okay, we’re going to target these groups to diagnoses and so it could be easiest to say, let’s target diabetic patients first. And that’s a strategy that some groups will use to say, our care team while they’re learning this program and getting started. Let’s focus on a single diagnoses that we care for will work with their other diagnoses. That will be the main care type that we’ll focus on. Next, let’s add hypertension congestive heart failure cardiac patients, after we’ve got you know, 50 to 100 diabetic patients going so that’s a little bit easier than just throwing random patients in with random diagnoses. It just streamlines your staffs calls a little bit easier. But if you’ve got a staff member that knows how to work with patients, it doesn’t really matter. Now when ramping up we want to talk about is next is their insurances and so when identifying patients in the MDS office we talked about the copays, meaning. It’s going to be the same rules as if they go to the physician’s office. So if you’ve got a pharmacist or sorry, if you’ve got a patient that’s on Medicare Part B only, they don’t have a supplemental insurance, they don’t have anything else. Those are patients that are going to have a 20% copay. For whatever is billed out, so just like if they go to the physician’s office, they pay 20% of whatever is billed out for that office. Visit. And so the physician will know who those groups of patients are, will want to put them to the side for now, when we’re getting started. Just because patients they do or don’t pay their co pays, it starts to become a hassle that the physician knows who those patients are and so we can push them off to the side for the first few months. But let’s target patients that have Medicare Medicaid, dual eligibility. Let’s target patients that have supplemental insurances. So they’ve got Medicare Part B, but then they have a secondary insurance as well. Those two groups of patients are going to be 100% covered. So and if not 100%, covered, highly subsidized to copay. That’s what those secondary insurances are for Medicaid covers the full copay, and the secondary insurance does cover all of it. If not the majority. And then we want to look at Medicare replacement policies which are the same as the other ones and then Medicare Advantage Plans Medicare Advantage plans will just vary, so we’ll we’ll put them last in these in the sport groups so it’s Medicare, Medicaid, supplemental insurances patients with supplemental insurance or secondary insurance, Medicare replacement policies and then we look at Advantage plans and Advantage plans. It just depends on what type of advantage plan it is. If they are fee for service where they’ll pay for every activity, then it should be very similar to the other ones if their risk based model Advantage plan. Basically, the physician or the group is getting paid per patient per month anyway, and so they’ll still pay for these activities. It’ll just come out of that budget of what they’re getting paid monthly. And so in the long run, or in the big scope of things. It does save them quite a bit of money, especially because they’re essentially Medicare at that point. They’re basically the insurance company. So if you’re keeping these patients out of the hospital, if you’re keeping these patients happy, healthy. What they have to pay out of pocket for those patient leads is far less than what they would be paying for these programs. But we just hold off on those patients until later just like the co pays. Because if we can do the patients that are 100% covered at first, that’s where we want to ramp up and we say let’s get to 100 150 patients before we start adding those other patients. Once you get to 100 patients, the physicians start seeing the revenue coming in from these programs. And it’s very easy to see the value in them and so, that’s that’s one of the key points when we’re looking at setting up for success is how to ramp up quick enough so that the physician sees value and you don’t plateau. Now, when you first get started with a physician, or when you’re speaking to a physician about a partnership or anything like that, oftentimes it’s very common that people will say let’s do a pilot program. We’ll get five patients in there. We’ll run this for six months. Honestly, that’s a waste of time. It it’s a it’s the waste of your time, the physicians time. Mainly your time because what happens is you’re putting all this effort into getting this program running started. And then you only have five patients to work with. And so what happens is month one, first week, you talk to all five of those patients, maybe 10 of those patients, you get them completed for the 20 minutes, maybe you follow up with them here and there throughout the month. But it’s very little of your time throughout the month. And so month two, you’re a little less efficient. And then month three, you’re even less efficient, and it just doesn’t become part of your daily routine. It doesn’t become part of your your organization. Because there’s too few patients to focus on. And so it becomes a very low priority. So by the end of those six months, whatever, that pilot period, you’ve only got maybe 10 patients running. The physician barely sees any revenue. You barely see any revenue.
The patients are okay but the majority of them feel that towards the end of those six months. You know, there wasn’t much of a focus on it or whatever. It’s just not successful with all the groups that we’ve worked with in the past. And so that’s where we we recommend if you are going to do a small group of patients, just let the just let the physician know we’re only going to do a small group of patients month one. And the reason the majority of the reason why you would do that is only if the physicians wondering, well do these codes really pay out that rate? Like am I really going to get a $60 reimbursement for 20 minutes of your time. And so if they’re hesitant to that, that’s where you could say, alright, let’s take a patient from each insurance type. And we’ll work with all five or all entities, you know, and just identify different insurances. Throw them all in here. Work with them for 20 minutes and let them fill out this code at the end of the month, that nine and 490. And then we can see oh yeah, it is getting reimbursed. It is what we’re seeing. Now let’s ramp up so now, month two month three we’re going to focus on trying to enroll 50 patients per month. And so if we can enroll 50 patients per month, that’s really where the physician is going to see program, the benefits of the program and it’s going to give you the pharmacy and your staff, a patient base to focus on and so if you don’t have a big enough patient base to focus on that’s really where a lot of these programs will plateau. Whether your physician’s office pharmacy third party group doesn’t matter without that minimum 50 patients to focus on it becomes like I said earlier, just lower prioritization in whatever tasks you’re working on, and then growth starts to just plateau. And so what we want to do is first month you really go get 50 patients, then work on getting up to 100 the next month, and then month three, we can start slowing down because hundreds, okay, but if you’ve got a full time employee, do another 50 So now you’re at 150 and until you get to 200. Don’t let that enrollment period slow down. Then what will happen is, now that you’ve got those 200 patients with that single physician couple months go by, you’ll have really good numbers and really good statistics. To be able to go to another physician and say okay, let’s take a look at this because we can we can talk with you guys and look at numbers of previous clients stuff like that. pharmacies that have had partnerships. For example, this one they’ve got three different offices they work with. They generate about $30,000 per office per month, and they get about $20,000 of that. So the physician keeps just under 9000 of that per month. And so you could take these numbers and show them. But once you’ve got that physician partnership for yourself, and you can confidently go to the next physician and say, Hey, I work with Dr. Smith down the road. We make him you know, $9,000 a month working with these patients, and we’re going to be sending them home with devices. We’re going to be speaking to them in between office visits, and get new escalation so that you can work within your scope of practice even better. That’s going to be a huge feather in your cap by making sure that that first position was successful. Growth is gonna go crazy after that. But yeah, if we don’t if we don’t set those expectations on needs, we need to make sure we can if we don’t have somebody now, we know when we’re going to hire somebody full time to dedicate to this. We wanted to dedicate to inpatient enrollment towards the beginning to make sure we can get close to that 200 patient mark. When we’re setting up with the physician, I want to also make sure that we set up an escalation tree or an escalation path. And what I mean by that is, it can even just be on a sheet of paper, we write doctor at the top staff member at the bottom when the staff member has this type of escalation, so it’s a vital alert. That was worse than a warning, maybe like a critical alert at this tolerance for blood pressure. This is when we would escalate to the pharmacist. Now the pharmacist will escalate to the physician if this parameter is met. And so we just lay out at what point are we escalating. And so we’ve got these written rules that we can say staff member. If anything like this happens, escalate to the pharmacy. If anything like this happens to the pharmacist. if anything else happens you can call directly to the office staff at the physician’s office report that so just setting those rules of when to talk to who is going to make a big deal as well. As far as your success goes and the physician will see very big benefit from that and making sure that you’re escalating internally will help so that the physician doesn’t feel like they’re getting hammered with a bunch of questions all the time either. And so when, when possible with your staff, if you could at some point hire maybe an RN or somebody that has a little bit more medical experience, but not quite as much as a pharmacist. So you’ve got this middle escalation point. So now you’ve got your technician, your ma your, your lower level staff member that’s doing a lot of the day to day data gathering information. When something is added parameters now let’s go to that RN who will be able to handle some of the escalations within their scope of practice or within their scope of care. And then they know when to escalate to the pharmacist and they know when to escalate to the physician and so that’s the escalation tree or model that we’re we’re looking at there. And then I’d started mentioning scope of practice. And that’s one thing that we want to set expectations for when getting started as well. Is your scope of practice is going to be with every staff member, what tasks what activities can they perform, that are going to be able for them to handle able to do daily, and then again when de escalated when it’s outside of their scope of practice. But we can we can dig into that more later too. But those are the main focuses that I wanted. To talk about is when to dedicate a ccm RPO manager full time. Our plan on enrolling patients within the first six months or first four months to get that 200 patient Mark having an escalation path potentially looking at hiring like a mid level medical personnel for that escalation path as well. And then making sure that your team works within their scope of practice. If you’re going to do a pilot program don’t do it for more than one or two months. Especially if it’s a very limited group of patients. You’ll find that after two months, it’s really not beneficial. And the doctor kind of just drags you along. It’s not as successful. And you don’t, you don’t get the results you’re thinking you’ll get and so if the physician wants it for longer than two months, we can we can circle back and talk about why it’s not beneficial. Look at all that but we’re able to help you with that too. And then just making sure that if you follow these, your program won’t plateau. What we see sometimes is that people get up to about 20 patients already patients and just stick with those patients because they don’t have enough time to run the program. And that’s the exact same fail point that physicians offices have. And so again, I know I’m hammering on this but making sure that we’ve got a dedicated staff member to be the manager is going to be key. And I said this earlier but if you’re the pharmacist running this, it’s okay for you to be the key point and the main the manager at the beginning of this program. But after a couple months is when we want to bring somebody else on and start turning up that dial. That’s pretty much what I wanted to talk about for as far as setting expectations for success. Do you guys have any questions or want any clarification on anything we’ve discussed for that?
You know, I’ve got a couple of questions. Yeah,
let’s do it.
What about that position that says I can I can do this myself. What what? How do you answer that?
Yeah. So if a physician says I can do this for myself, I call baloney. It’s very uncommon that we see a physician’s office running this successfully themselves. And in fact, the only way that they’re doing it successfully is if they do what I just talked about, where we say we’re, we’re hiring a single person to be the CCM RP manager. And this is their full time job. In fact, as a software solution we started when we first got started, we targeted independent physicians offices only. And the amount of clients we still have from the beginning, I can count on one hand, oftentimes, they won’t last longer than six months running it by themselves. No matter how much coaching we give them, no matter how much we work with them. It’s just not common for them to hire somebody or to take a staff member and pull them off throughout their projects and say this is your dedicated full time activity. And I know I harp on that harp on that a lot. But what that means is now that you’ve got somebody that’s really dedicated to this program, and its success, and even if everybody else tag teams puts time in here, time in there, so we get cumulative time over the month. Having that single staff member is basically the only way to drive this success. Yeah, we’ve got pharmacies that will have. Well, one pharmacy example that I can think of right now is she got started doing this on her own, but then quickly hired a staff member. What happened is she was working with a nurse practitioner and they only got to maybe, you know, 150 patients or so. But they were running it for a good seven months. And so that was good enough numbers to be able to go show other physicians stuff like that. But that nurse practitioner started talking to other doctors in the area and a hospital group reached out to her and said, Hey, we want to give you our business. And so now she’s looking at who do I hire to manage the pharmacy so that she can take take the reins over on the CCM RPM side and manage that daily. But she gets that you need to have somebody full time to manage it in order for that growth, and that’s where that just doesn’t happen with the physician’s offices. And so, in response to them, you could say we could talk about that scenario. But if they just want to try it out for a few months, say yeah, try it out. We’re going to support you. So run this yourself. We’ll support you, help you grow. And the patients that you can’t care for, send them over our way. So let them work with 50 patients and then the other 100 patients you take over. They’ll find that they’ll make more money with the patients that you work on because you’re able to get more patients done than if they were doing this themselves. But if they’re completely against that or whatever. Let them run it and six months later, come back to them and say hey, I want to try again. Let’s get this going. We’ve been working with Dr. Smith down the road. This is what we’ve been able to do for them over the past four months. This is what we’d like to this is what we think we could do with your group.
My other question and you may have already entered and my mind might have wandered it when you were saying this but before I had a high volume pharmacy and sold it now I’ve recently reopened and I don’t have a significant a significant amount of volume with any one physician. I have a mutual base of patients. Does that matter? Early on and in in the pharmacies, infancy stages here. Can I still go to a physician and grab patients from other pharmacies within that physician’s office? I didn’t know if you were kind of alluding to what you were saying there. What are your thoughts on that? How does that work?
So we hadn’t talked about that yet. Rick, that’s a great point to bring up. And so it’s really helpful when initially trying to outreach to that physician to have mutual patients. That’s that’s the only time where it’s really helpful as far as getting this program running, because you can go to that doctor and say, Hey, we’ve got 50 patients in common. But if we only have four patients in common, that’s a little bit harder. But that being said, it’s not impossible either. So with these programs, you can run it out of the pharmacy. The majority of pharmacies that we work with will actually start a new LLC so that the money goes into a different account anyway, that gets paid. We’re still working from the pharmacy, stuff like that, but basically, you’re you’re creating a third party rpmc cm company no matter what. And you’re going to that physician saying we want to work with your patients. Doesn’t matter if they’re in the pharmacy or not. We’re going to start with the ones that are in the pharmacy. And maybe if we only have five that’s that first month pilot program five that we’re just saying, let’s test it out for a month and you can see you know the numbers do come back with what we’re telling you. But after that you can really go with any patients, as long as the staff members that you are using to speak to patients have some sort of credentialing license, something that they’re able to work in the state for the patient lifts so if they’re halfway across the state, you can still work with them. Because it’s all non face to face care anyway. Some, some care like the examples I gave where somebody comes into the pharmacy and you speak for five minutes after filling the prescription, that face to face time still counts. Face to Face Time still counts, but the majority of it’s done non face to face remote. The only time face to face time doesn’t count is if it’s being billed under another billable activity. So if you’re running or if they go in for an office visit, the time spent in that office visit is now not billable towards these programs. You know, it’s another activity that’s already been build. These are going to be activities that normally aren’t built that will pull together and create these 20 minute increments with but yeah, you don’t have to have a big pool of patients that are joint mutual patients. But having some helps to get that initial interest with the physician that sometimes sometimes people will start at the CCM or RPM program in hopes to get more patients into their pharmacy and it can happen but we don’t focus on that just because of the Stark law setting up the setting up everything as a fee for service. We want to avoid Stark Law stuff like that. With all the groups that we have, it’s really not an issue and what you’ll find is you can bring patients in for little activities here and there. One thing that a lot of groups will do is you can set up custom tasks and say hey, we’re going to do a flu shot program where it’s the fall this month, or it’s the fall this year. And so by the end of September, end of October, we want to make sure that all patients have gotten their flu shot, whether it’s in the pharmacy, whether it’s from Costco, whether it’s in the physician’s office, we just want to confirm that they’ve all gotten it. And so we call a patient one say hey, have you gotten your flu shot yet? You did awesome. You just got there at Costco when you were there. Cool. Hey, have you gotten your flu shot patient number two. Okay, you got out at the doctor’s office. Perfect patient three. I haven’t gotten it yet. Oh, do you want to just come down to the pharmacy tomorrow and we’ll get that taken care of for you. Great, let’s do it. And so there are these little activities that you can gather and start pulling people in. But that’s not going to be the main focus of the programs. You’re gonna get much more money just spending the time getting these 20 minute increments, then pulling people in for this or that. But those are good additional incentives while working with these patients. And that’s where you may see some increase of patients where if they can come into the pharmacy at death, they may say, Well, let’s start filling our prescription there. I really liked the team there. I speak with them a lot. And that’s how we’ll naturally grow patients there. But it won’t be rapid or just real big at first, you know, once you have that better relationship with patients. That’s where we’ll start to see some more natural growth. But yeah,
and I have a question that a lot of pharmacists have asked me is the actual getting started and getting that act as record kind of mentioned getting into the provider. Yeah, do you recommend that the pharmacist themselves walk in the door to to to promote this system or would you say some hire marketing people to market they’re compounding other areas of their business? would that person be a good person to walk in there and talk about this partnership side of it, as I see really is kind of a partnership that they’re you’re turning your staff into A into their pseudo staff and away right there so yeah, if they’re using Sony they’re all staff is rich bunch and someone’s gonna do it on their own. Hey, that person you have to pay for benefits. But have you ever had that person? I’d say you should get rid of them just never had to focus on that you bring us on board. You don’t have to pay anything for our services. We’re paying you.
Yep. And so there’s a couple different ways you could go about it. I think all of those methods are valid, but let’s walk through. So the first thing that I say with the pharmacist when we’re talking is how many independent physicians do you know in your area? We’re going to target independent physicians first, maybe specialists in the area of people that don’t get a salary from a hospital organization or a health group. Just come up with a number in your head, start thinking about who you who we could reach out to now, of those physicians, how many do you have a good relationship with that maybe you’ve got their cell number that you could just call up and talk to him about a patient needed or just have a good relationship with now we can kind of start sorting those into different categories. positions, you don’t have a relationship with really, those are the ones that I might send, you know, if you’ve got somebody already go into the office to talk about a different program, throw this program in there and just see what their what their thoughts or needs would be with them. If you’ve got a relationship, I just talked to him personally either walk into the into the physician’s office, if you to walk in, bring a blood pressure monitor, whether it’s one that connects to the software or not doesn’t matter. But just having something physical with you to say, hey, they’re gonna take their blood pressure. We’re gonna see it on our software. And we’re going to talk to you about it. When I even go to a physician’s office visits for personal reasons. I always bring your blood pressure monitor, and I just pull it out and like, look at what I do. I can connect this to, you know, send the data and your EHR they get well that’s so cool. You know, having something physical, they really enjoy the touch the feel of it. And that’s where RPM is like a really easy sell for them to talk about rpm. Once you’ve got their attention. Now let’s talk about CCM. Not only to get paid to see what to remotely monitor a patient, but you’re gonna get paid for the time that I spend talking with those patients. How does that work? Well, let me tell you and so that’s, that’s if you go in in person, if you call them you could just call them and say hey, I’ve heard about chronic care management. I’ve heard about remote patient monitoring. I’ve been thinking about maybe looking at this in the pharmacy, is this something you guys have looked into and just kind of try to have a casual conversation with them. So the first couple of minutes just so that they’re they don’t get their hackles up and they’re not like feeling like they’re getting sold. But just talk about the programs. Is that something you guys have thought about doing in your office? Okay, you have thought about it? What do you think? We’re thinking about doing it here in the pharmacy and partnering with different offices? What if we partnered and really made this, you know, a big deal for all your patients and start start going at it at that aspect? Yeah, if you’ve got a good relationship with a physician, absolutely reach out to him as soon as possible even just to get their feedback
any other questions? Guys at all I have been on here
Alright, any other further things in that you want to close out with but I’m going to share email. Is that okay?
Oh, absolutely. Yeah. Shoot my email out. I’ll answer any additional questions. But yeah, if you want to take a look at software if you want to take a look at partnering with physician other things in depth, I’m happy to jump on a one on one call and we can go over any questions
Yeah, so before that was this lecture.
Oh, Bread. Bread. Sorry. Oh, yeah.
No before when left he was working on something with me to use for a hospital group. I was trying to get in more information together to send to a hospital contact that you have access to his emails or do you miss anyone or?
Yeah, I can do that. So if you want to shoot me your latest email and then let’s start working on something for this hospital group. Do you know are they like on a risk based model? Or would it be more fee for service model? Or maybe you don’t know that yet? Oh, yeah. So
I contacted a consultant on something else that I’m working for. And the consultant actually put a pause in the consulting job. It was doing work for a hospital group. And so I started talking to him about somehow started talking about the patient boundary. And he was like, Oh yeah, put an email together for me and I’ll take a look at it. When Brian left and I got sidetracked and I’m trying to pick that back up the pieces. So anyway, yeah, I’ll send you the last email I sent to Brad. If you can take a look at it for me and help me put some time
yeah, let’s do it. Thanks, Tommy. All right.
What’s your email address and your shared
chat right now too. So it’s EA n at value care suite.com.
So I get that right. In
you. Oh, you know what? The S at the end of value here sweet. Is not there. So it’s in that you care. Sweet. Okay, yeah. That’s it.
All right. I’ll let you guys have the rest of your day back at least so he says it’s almost been here an hour and any feedback we’d love. Ian’s got an exceptional tool that I think not enough independents are utilizing it but if you guys told me already in it, I hope it’s going to be successful for you. Lie on your feet. Yeah, keep keep on don’t give up.
Having a conversation in the doctor’s office is not always the easiest. choice. Do we have a Debbie Downer in the office about it? There’s always somebody holding it back. It seems like especially the physician’s office like they’re like oh yeah, I want to make money into the office staff is like, wow, there’s all kinds of negative crap. These people are bringing your business down and you get back to the sell out to somebody else because you can’t make ends meet but often you $15,000 a month in revenue for nothing like thought. But anyway, so I’ll make one day and we’ll get some money. It’s gonna be awesome.
All right. Perfect. All right, guys. So thank you again, he and we’ll we’ll be meeting again in what four weeks so remember, always third Thursday of the month, we’ll meet up and talk about this and we’d love to hear your victories and rec we will help your success with it. And we’ll move forward again. I’ll let everyone go and thanks for your time.