The reimbursement changes brought on by the Affordable Care Act, MACRA, and Alternative Payment Models, are requiring physicians to take a more proactive and preventative approach to patient care. It is anticipated that by 2019, more than $20 billion in payments will be guided by outcomes measures.
Creating better outcomes requires a new level of care coordination, along with the personnel, technology and other resources to engage patients in their own good health.
To facilitate this massive shift from fee-for-service to fee-for-value, CMS has inaugurated a new Chronic Care Management reimbursement – the first non-face-to –face reimbursement – to allow physicians to provide care outside the office setting.
Fitzpatrick Lentz & Bubba recently assisted Signallamp Health, a start-up that provides remote Chronic Care Management services, in turning its concept into a successful b
usiness. Signallamp Health works as an extension of the physician’s office and assigns RNs to build 1:1 relationships with Medicare beneficiaries. Signallamp leverages technology and data collection to track patient adherence to their plan of care, medication regimen, and their own personalized goals. Signallamp Health activates patients in their own good health, extends the physician’s reach outside the office, and generates new practice revenue.
Many practices consider implementing Chronic Care Management on their own, but find the administrative, personnel and technology requirements overly burdensome. By partnering with Signallamp Health, practices are able to deploy chronic care management services 1) to their entire patient population, 2) at no cost to the practice, 3) with RN resources, and 4) with no technology integration. Since launching in 2015, Signallamp now works with more than 40 physicians and has 30,000 eligible patients under contract.
How Did FLB Law Help Signallamp Health?
Early in their development process, Signallamp Health approached FLB Law with an innovative business concept. Our experienced attorneys, shareholder Steven Boell and associate Ken Charette, applied the existing healthcare regulatory framework to the new Chronic Care Management program that Signallamp Health is targeting. Together, Steve and Ken investigated:
- Regulatory compliance issues with the Stark Law, the Anti-Kickback Statute, the False Claims Act and HIPAA;
- Business structure options;
- Healthcare documentation requirements;
- Provider agreements;
- EMR agreements; and
- Medicare billing requirements
Through their research, FLB Law’s sophisticated and diligent attorneys helped Signallamp create the business and compliance structure needed to define the breadth of their novel business model and build a long-term foundation for growth.
