Self-Assessment Calculator

What could proactive care look like for your healthcare organization?

Healthcare organizations looking for new ways to drive value-based care outcomes are increasingly using fee-for-service programs to fund the transition. What could that look like for your organization? Answer a couple of questions and we can show you.

This quick quiz will help you understand the impact proactive care can have on your patients and your practice. We’ll identify the best Medicare FFS model for you and give you the benchmarks you need to set up and scale an effective program at your organization.

What type of program do you want to run?

Primary Care Specialty Care

Do you know how many Traditional Medicare and Medicare Advantage patients you have?

(This will make your assessment more accurate)

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How many Traditional Medicare and Medicare Advantage patients do you have?

patients

No worries! We'll calculate your results based on your number of physicians and APPs instead.

How many physicians do you have?

physicians

How many APPs do you have?

APPs

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Part 1 of 3

We recommend an Advanced Primary Care Management (APCM) program for primary care.

We recommend a Chronic Care Management (CCM) program for specialty care.

APCM is designed to help practices deliver better between-visit care to all their Medicare patients. By removing time- and condition-based requirements, APCM makes it easier for you to focus on delivering the care patients need at the right time for them. Learn more about APCM and why it’s a good fit for primary care practices.

CCM rewards practices for providing better between-visit care to Medicare patients with 2+ chronic conditions. Specialty providers use CCM to improve outcomes, increase medication compliance, support better self-management, and lower the total cost of care. Learn more about CCM and why it’s a good fit for specialty practices.

An APCM program at your organization could look like...

A CCM program at your organization could look like...

Patient engagement at population scale

With text-based care management, your organization can scale high-quality, consistent care to all of your eligible patients, all year round.

((([patienttype]-2)*([patienttype]-2)*[numberpatients]) + ([patienttype]-1)*(([numberphysicians]*225)+([numberapps]*150)) )*16.32

patient conversations per year

(([patienttype]-2)*([patienttype]-2)*[numberpatients] + ([patienttype]-1)*(([numberphysicians]*225)+([numberapps]*150)) )*0.4/ ((([orgtype]-2)*([orgtype]-2)*750) + ([orgtype]-1)*500)

FTE(s) needed

Consistent communication for early intervention

Delivering consistent care across your patient population accelerates early intervention, closes care gaps, and reduces unnecessary ED visits.

((([patienttype]-2)*([patienttype]-2)*[numberpatients]) + ([patienttype]-1)*(([numberphysicians]*225)+([numberapps]*150)) )*2.6

total care gaps closed

((([patienttype]-2)*([patienttype]-2)*[numberpatients]) + ([patienttype]-1)*(([numberphysicians]*225)+([numberapps]*150)) )*760

TCoC reduction ($)

Consistent communication for early intervention

Delivering consistent care across your patient population accelerates early intervention, closes care gaps, and reduces unnecessary ED visits.

Better care means better business.

Care management is self-sustaining — capture more revenue for the between-visit work your employees are already doing.

(([patienttype]-2)*([patienttype]-2)*[numberpatients] + ([patienttype]-1)*(([numberphysicians]*225)+([numberapps]*150)) )*0.4* ((([orgtype]-2)*([orgtype]-2)*578) + ([orgtype]-1)*700)

revenue per year ($)

[revenue]/2

profit per year ($)

Part 2 of 3

Patient engagement is the key to APCM success

Patient engagement is the key to CCM success

Done well, this program provides a model of continuous care that builds trusted relationships between patients and providers.

Net Promoter Score

monthly patient
engagement rate

0 %

conversations per month

Every conversation is a new opportunity for early intervention.

The more your patients engage, the more value they see from the program and the more billable events they generate. An engaged patient population is the key to building a self-sustaining, profitable program that enables you to reinvest in new initiatives.

What does good patient engagement look like? These are our benchmarks from similar organizations we work with.

Part 3 of 3

How to scale engagement across your patient population

APCM was designed to help you support your entire patient population, but scaling care to that level isn’t easy. Here’s what it takes to remain consistent at scale.

68% of Medicare beneficiaries qualify for CCM, but extending your program to the majority of your patient population isn’t easy. Here’s what it takes to remain consistent at scale.

Traditional proactive care methods are slow and labor-intensive, resulting in limited programs with high overheads. Using AI-powered technology and turnkey staffing, organizations can enroll more patients, faster, while delivering the same consistent, high-quality care.

What capabilities do you need to scale your program?

To drive meaningful impact, you need to extend proactive care to as many patients as possible. Here are some of the capabilities you’ll need to grow your program successfully.

Effective patient outreach:
Traditional phone calls can create complexity and frustration while reducing proactive care to a single point in the month. Instead, look for new technology that enables and accelerates two-way communication.
Care consistency:
Ensure your program infrastructure includes guardrails and guidance to quickly ramp new team members and enforce best practices, regardless of turnover or staffing changes.
Documentation & compliance:
Keep your program audit-ready with thorough, standardized documentation and comprehensive recordkeeping that aligns with auditor expectations.
Integrated workflow:
Create policies and procedures around charting conversations, escalating concerns, and triaging questions. How will you train your care managers, and how often should you review your handbooks and improve on what you’ve learned?

Many organizations struggle with the complexity of implementing these capabilities.

We’ve helped 150+ healthcare groups overcome challenges and launch successful proactive care programs using our AI-enabled platform.

Whether you’re thinking of running proactive care in-house or you want to outsource using a full turnkey solution, our expert advisors can offer advice and guidance on how to evaluate the right program model for your organization and help you drive success at scale.

Get a Customized Financial Pro Forma

Meet with one of our expert advisors and we’ll provide a free financial model customized for your organization.

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