Strategic Business Plan Proposal to Further Expand Internal Patient Outreach Services that Promotes Wellness and Chronic Care Compliance

Fellowship Paper - March 16, 2021

This business proposal is for the expansion of our current patient outreach service, WellTouch. WellTouch is an independently operated division and subsidiary corporation owned by Piedmont Internal Medicine, PC (PIM). PIM is a privately owned and independently operated primary care physician (PCP) practice specializing in adult internal medicine. This plan is to expand current patient outreach services that focus on patient wellness, proactive chronic care management, and quality metric reporting to governmental and private insurance agencies.

WellTouch began as an internal patient outreach program involving the Medicare “Risk Adjustment Factor (RAF)” program and private commercial insurance carrier quality reporting programs based on “Healthcare Effectiveness Data and Information Set (HEDIS)” measures. These services have enabled the practice to capture passive income by completing and submitting additional documentation for which insurance companies reimbursed. It also ensured the tracking of correct and detailed reporting of quality metrics resulting in increased quality performance scores. This enhanced the overall patient experience through proactive and consistent contact with dedicated Piedmont Internal Medicine, PC staff members; and increased patient volume on physician and mid-level provider schedules, resulting in improved patient compliance through both preventive services (annual physicals and wellness visits) and chronic care management.

Over the past few years, our processes have evolved due to changes with CMS and commercial insurance reporting of quality metrics and the inclusion of the Piedmont Clinic/Piedmont Health System ACO (a health system Piedmont Internal Medicine, PC is contractually aligned with) quality metrics reporting. The evolution of chronic care monitoring and quality metric reporting through the incorporation of Telehealth and Telemedicine, current and pending changes with Current Procedural Terminology (CPT®) have positively affected reimbursement. With the expansive role patient experience now plays in reimbursement, Piedmont Internal Medicine, PC and WellTouch now see opportunities to improve patient care, patient outcomes, and generate new revenue streams.

This plan will outline and explain the various opportunities our current WellTouch program intends to capitalize upon, including the continuation of our goals to promote preventative medical care initiatives, wellness, proactive chronic care management, enhanced patient care experiences, and bringing increased revenue streams into the practice.

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