Consulting Services

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Optimizing The Opportunity

The Passage of the ACA and the movement toward advanced payment models have overhauled the American healthcare system. A greater emphasis on population health and valued-based care is significantly driving efforts to improve quality outcomes while reducing costs. It is expected that both providers and payors will continue to be challanged to innovate and design programs that allow for greater reimbursement of population health initiatives.


It is at this intersection, our team assists organizations to adapt and even thrive under these new demands. Through careful analysis of existing technology and workflows, we help organizations large and small capitalize on their unique structure to meet the challenges they are facing. 


In every engagement we identify and address the Five P's of Population Health


1. Problem -  Greatest Need

2. Population - Medicare, Medicaid and Commercial lines of business and/or Chronic Conditions, Prevention and Wellness

3. Policy/Program - Value-Based Care Programs and Risk Models for Fee-For Service, Managed Care and other Quality Initiatives

4. Payment - Incentive Programs and Advanced Payment Methods (APMs) 

5. Procedure - Strategy and execution of an achievable population health program that is compliant, sustainable and reimbursed


To this end, we provide the following services:

Opportunity Assessment

Our team of experts will evaluate your specific needs providing deep analytics and expertise in the areas of systems integration, technology, quality programs, population health, wellness, chronic conditions, disease management, transitional care, alternative payment models, value-based care, public policy, public relations and the identification of new sources of revenue.

Strategic Planning

With a deep understanding of healthcare systems, public policy and analytics and a passion for transforming healthcare with new technology and innovations, we assist organizations in obtaining their unique initiatives and goals. 

Project Management

Skilled in PM principles, process improvement and organizational effectiveness, we assist teams across an organization to accomplish well defined project objectives and milestones that reflect outcomes that are measurable, sustainable and meaningful.

Implementation

Great execution is at the heart of all we do. Successful in systems integration, program evaluation, curriculum design and training, we engage and empower health care teams toward greater efficiencies and optimal workflow redesign that provides increased quality, satisfaction and affordability. 

Care Management Programs

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Chronic Conditions Management and Behavioral Health

On January 1, 2015, CMS began paying for non-face-to-face care coordination services for Medicare beneficiaries with multiple chronic conditions under new CPT codes allowing for physicians and organizations large and small to finally be reimbursed for valuable services provided to their patients. By January 2016, information suggested that only a very small number of providers were meeting the standards to be able to bill for those services. It was clear that something needed to be done to assist others in implementing a new strategy to capitalize on the CPT codes and their corresponding standards. In November 2016, further data supported this claim as public policy moved steadily toward chronic conditions management programs that consider aspects of behavioral health and social determinants of health on patient-centered value-based models of care. 


As a result of these efforts, CMS created new behavioral Health codes allowing for greater integration of chronic and complex chronic medical and behavioral health conditions. In January 2017, theses codes, allowed for greater reimbursement of services provided across the continuum of care. Organizations and Healthcare Systems are just now beginning to implement this new approach.  


The CCM implementation team at Virginia Burchett Consulting is confident that your organization has the ability to develop a fully reimbursed CCM Program and want to partner with you in achieving this goal. In working with our clients, we have determined that implementation and compliance issues are keeping providers from fully pursuing this new source of revenue that will also allow them the opportunity to improve the quality of healthcare they provide. Many institutions are already working on a CCM solution and need just a little guidance and some on-the-ground system integration review, workflow adaptation and physician office training and on-boarding expertise to successfully build a robust CCM program. 

Our Services

We’ve created a CCM implementation service that is fully customized to your organization’s needs. Our dedicated and knowledgeable team will work with you through an innovative project management approach that will allow you to begin enrolling and billing patients within the first month of implementation. With this offering, you receive the following: 

  • Expert consultation in all matters related to CCM
  • Personalized CCM Opportunity Assessment which includes a complete cost benefit analysis and Return On Investment (ROI)
  • A tailored and individualized implementation project management plan strategically created from key indicators identified in your organization’s Gap Analysis
  • Powerful and effective facilitation and project management skills using industry best practices    
  • A dedicated account manager and single point of contact from the beginning of the implementation process to the end with the goal of achieving CCM reimbursement within the first month of implementation
  • A team accountable for monitoring your program’s regulatory consistency who will provide assistance making modifications to technology and clinical operations workflow redesign

Our lead CCM implementation consultant is Virginia Burchett, MPH, who has 25 years of experience with Kaiser Permanente leading initiatives that required physician office and support staff education specifically in the area of Chronic Conditions Management and IT solutions. Virginia will personally oversee the entire implementation process to ensure that your CCM program obtains and continues to maintain program consistency. 

Physician Practice Education/Training

As your dedicated account manager, Virginia will lead a team of experts to provide the following implementation deliverables and continual support:

  • Scope and risk assessment – SWOT Analysis and Milestones/Objectives Development
  • Budget and time allocation – Daily time management, task tracking, reporting and outreach to those assisting in the completion of CCM implementation
  • Personnel requirements within and outside the organization – Review and recommend staff and budget allocation to meet CCM requirements
  • Work Flow Charting and Process Improvement(Visio, RPI, Control Charting, LEAN Techniques) – Create documentation and diagrams essential to maintaining a comprehensive CCM program and embed Principles of Rapid Process Improvement (RPI) and LEAN techniques for greater organizational effectiveness
  • EHR Review – Review current functions of internal IT systems to ensure achievement of CCM program standards and provide expert guidance on IT solutions and training for full implementation
  • Training and curricula development – Create or adapt current materials, curricula (PowerPoint, handouts, and surveys) and provide in person, or virtual/ recorded training for any area of your CCM program
  • CCM Publications – Evaluate existing or create new consent forms, brochures, posters, and marketing materials to ensure that CCM program language and standards are integrated into your organization’s current brand. 
  • Training Personnel – Our team will “train the trainers”. This involves bringing selected personnel up to speed on all aspects of CCM, which will allow them to train others across the system on CCM implementation on an on-going basis.
  • Continual CCM program review – Your dedicated account manager will continue to provide regular updates, training and support to ensure regulatory consistency is maintained.    

CCM Software Solution & System Integration Review

Under the direction of our System’s Integration Expert, Eric Odero, our team will provide a complete review of your CCM IT needs ensuring that a solution is found that meets your specific EMR and system integration and CMS CCM IT Solution requirements.

Pulling it all together

We are confident that like other organizations we've partnered with, you too can create a robust and thriving patient-centric CCM program - one that considers the whole person including behavioral health and social determinants of health. Together we can impact the quality of life for many with a cost-effective quality outcomes-driven model of care.

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VBurchett Consulting

Rockville, MD 20850, us

(240) 687-9494

Hours

Monday - Friday: 9am - 5pm ET

Saturday: By appointment

Sunday: By appointment