Last article we took a high-altitude look at a population health initiative. Today we are looking at how revenues and capabilities acquired within these core revenue lines help build a successful initiative.

These revenue lines are generated from Medicare-allowables but are transferable to other payer models as they all mostly follow traditional Medicare.

Transitional Care Management TCM, not to be confused with Transformational Care is right at the core, as it provides us the best chance to get started not only gathering data but getting those very sick and recently discharged from an inpatient acute care setting back in front of their primary care physicians. This is crucial as we find that many PCP’s are not aware of the inpatient stay and acuity that caused the admission, let alone the changes and or addition made to the patients care plan and medications. This is the first instance that we are able to coordinate medical treatment plans for better management of the patient’s disease. This is done in either a less than a 7 day CPT Code 99496 or a 14 day CPT Code 99495 window from the date of discharge for the patient to be seen by the primary care physician after discharge as a face to face. Revenues range from 130 to 200 dollars.