|
|
| Line 4: |
Line 4: |
| | | | |
| | [http://www.health3-0.com/reimbursement/ready-for-medicare-part-e/ '''Medicare Part E'''] are patient services that don’t qualify for Medicare Part A (hospital), Part B (physician), Part C (health plan) or Part D (medicines) reimbursement. Most health plans are based on Medicare fee schedules, so it is unlikely they will provide reimbursement either. Similar interventions may qualify for reimbursement (like home health), yet they comes with stipulations that may not suit the patient situation. It could mean a patient staying 2 nights in a hospital, would need to stay a 3rd night to qualify for Medicare (or other health plan) reimbursement for home health services. It could be telemedicine that is only reimbursed if the patient is in qualified physician office communicating to physician in a qualified physician office, thus no reimbursement for telemedicine into the home. | | [http://www.health3-0.com/reimbursement/ready-for-medicare-part-e/ '''Medicare Part E'''] are patient services that don’t qualify for Medicare Part A (hospital), Part B (physician), Part C (health plan) or Part D (medicines) reimbursement. Most health plans are based on Medicare fee schedules, so it is unlikely they will provide reimbursement either. Similar interventions may qualify for reimbursement (like home health), yet they comes with stipulations that may not suit the patient situation. It could mean a patient staying 2 nights in a hospital, would need to stay a 3rd night to qualify for Medicare (or other health plan) reimbursement for home health services. It could be telemedicine that is only reimbursed if the patient is in qualified physician office communicating to physician in a qualified physician office, thus no reimbursement for telemedicine into the home. |
| − |
| |
| − |
| |
| − |
| |
| − | ==[[Patient Activation Factors|Patient Activation Education]]==
| |
| − | [[Patient Activation Factors|Patient activation factors]] are elements of the [[Social and Behavioral Factors|social and behavioral factors]] in [[Patient Recovery|patient recovery]].
| |
| − | ===Condition Management Aptitude===
| |
| − | * Diabetic monitoring glucose and injecting insulin
| |
| − | * Self-care
| |
| − | ===Education===
| |
| − | * Diagnosis
| |
| − | * Prognosis
| |
| − | * Treatments
| |
| − | * Understand Options and onboard with the treatment plan
| |
| − | ===Treatment Adherence===
| |
| − | * Medication Adherence
| |
| − | * Nutrition
| |
| − | * Therapy, Physician Visits
| |
| − | * Recommended Activity levels
| |
| − | ===Intervention Activation===
| |
| − | * Know when to ask for help
| |
| − | * Comfortable asking for help
| |
| − | * Know who to ask for help
| |
| − |
| |
| − | ==[[Patient Technology Adoption Factors|Patient Technology Adoption]]==
| |
| − | ===Device Aptitude===
| |
| − | * Use of remote monitoring devices (Blood Pressure cuff)
| |
| − | * Use of remote diagnostic devices (ecg app)
| |
| − | * Use of tablet, computer or smartphone
| |
| − | ===Technology Aptitude===
| |
| − | * Internet and Online Usage
| |
| − | * Education Videos
| |
| − | * Patient Portal Usage
| |
| − | * Use of Secure Texting, Video Conferencing, email
| |
| − | ===Online Personal Health Record===
| |
| − | * Online Electronic Health Record
| |
| − | * Access Authorization (Recovery Team access)
| |
| − | * Patient Input History (Patient answer questions or inputs data into Personal Health Record)
| |
| − | ===Available Technology===
| |
| − | * Broadband Internet
| |
| − | * Wifi Router
| |
| − | * Computer
| |
| − | * Smartphone or Tablet
| |
| − | * Remote Monitoring Devices (Blood pressure cuff, blood glucose monitoring)
| |
| − | * Remote Diagnostic Devices (ECG app)
| |
| − |
| |
| − | ==[[Socioeconomic Status Factors|Socioeconomic Status]]==
| |
| − | [[Socioeconomic Status Factors|Socioeconomic status factors]] are elements of the [[Basic Needs Factors|basic needs factors]] in [[Patient Recovery|patient recovery]].
| |
| − | ===Financial Health===
| |
| − | * Income,
| |
| − | * Resolve financial or debt issues
| |
| − | ===Job Status===
| |
| − | * Getting a job
| |
| − | ===Education===
| |
| − | * Continuing education
| |
| − | * Literacy
| |
| − | ===Medical Insurance Status===
| |
| − | * Apply for insurance
| |
| − |
| |
| − |
| |
| − | ==[[Physical Environment & Setting Factors|Physical Environment & Setting]]==
| |
| − | [[Physical Environment & Setting Factors|Physical environment & setting factors]] are elements of the [[Basic Needs Factors|basic needs factors]] in [[Patient Recovery|patient recovery]].
| |
| − |
| |
| − | ===Home===
| |
| − | Location (proximity to services), Heat and Air conditioner, supportive
| |
| − | Safety
| |
| − | * Home repair, renovations and maintanance
| |
| − | ===Facility - Supportive===
| |
| − | * Evaluating Facilities Services (Nursing home, senior living center, etc.)
| |
| − | ===Temporary Housing===
| |
| − | * Homeless Shelters, Victims Centers
| |
| − | ===Equipment & Technology Services===
| |
| − | * Therapy Equipment (Oxygen equipment)
| |
| − | * Passive Sensors (wifi enabled weight scale, blue tooth enabled blood pressure cuff)
| |
| − | * Internet connection - wifi router
| |
| − | ===Temporary Housing Services===
| |
| − | * Homeless Shelters
| |
| − | * Victims Centers
| |
| − |
| |
| − |
| |
| − | ==[[Access & Logistics Factors|Access & Logistics]]==
| |
| − | ===Necessities Access===
| |
| − | (via delivery or going to the store)
| |
| − | * Medicines
| |
| − | * Food (via delivery or going to the store)
| |
| − | * Other
| |
| − | ===Transportation===
| |
| − | * Physician Offices
| |
| − | * Special Transportation Needs (Wheel Chair Vehicle)
| |
| − | ===Clinical Services Access===
| |
| − | * Same day access to Physicians
| |
| − | * Nights & Weekend Access to providers
| |
| − | * Clinical Care in area, region (i.e., dialysis)
| |
| − |
| |
| − | ==[[Recovery Team Factors|Recovery Team]]==
| |
| − | ===Clinical Providers===
| |
| − | These are licensed professionals.
| |
| − | * Physicians
| |
| − | * Physician Assistants, Nurse Practitioners
| |
| − | * Pharmacists
| |
| − | * Therapists (Speech, Physical, Occupational}
| |
| − | * Behavior Health (Psychologist, Psychiatrist)
| |
| − | * Nurse (Care Manager)
| |
| − | * Dietitian
| |
| − | * Education Providers (Clinical)
| |
| − |
| |
| − | ===Support (Social and Behavioral) Providers===
| |
| − | * Care givers (Family or fried)
| |
| − | * Recovery Navigator (patient navigator)
| |
| − | * Recovery Coaches (included MSW Social Workers and Health Coaches)
| |
| − | * Education (Non-Clinical)
| |
| − | * Technical Support and technicians
| |
| − |
| |
| − | ===Community (Basic Needs) Providers===
| |
| − | * Financial Counseling
| |
| − | * Meals Delivery (Meals on Wheels)
| |
| − | * Transportation Assistance
| |
| − | * Programs (Smoking Cessation, Weight Loss, Alcoholics Anonymous)
| |
| − | * Delivery Services
| |
| − | * Transportation Services
| |
| − | * Other Services (handy man, plumber, etc.)
| |
| − | * Community Health Services (Community Health Centers, free flu shots, etc.)
| |
| − | * Convenient Care (Minute Clinics, 24 hour services)
| |
| − |
| |
| − |
| |
| − | ===[[Recovery Plan Factors|Recovery Plan]]===
| |
| − | ===Discovery===
| |
| − | * Clinical Consults
| |
| − | * Qualified Option Development
| |
| − | * Testing
| |
| − | ===Treatments===
| |
| − | * Medicine
| |
| − | * Procedures
| |
| − | * Surgery
| |
| − | * Therapies (Occupational Therapy, Speech, Physical Therapy)
| |
| − | ===Activities===
| |
| − | * Nutrition
| |
| − | * Education
| |
| − | ===Recovery Navigation===
| |
| − |
| |
| − | ==[[Recovery Monitoring Factors|Recovery Monitoring]]==
| |
| − | ===Activities Monitoring===
| |
| − | * Track Recovery Plan to ensure activities, treatments are on track
| |
| − | ===Medication Monitoring===
| |
| − | * Adverse Medication Events
| |
| − | * Prescriptions Filled
| |
| − | * Medication Adherence
| |
| − | * Medication Effectiveness
| |
| − | * Medication Interactions
| |
| − | ===Medication Monitoring Method===
| |
| − | * Daily Calls
| |
| − | * Patient checks box or inputs data
| |
| − | * Passive sensor (wifi enabled pill boxes or caps)
| |
| − | ===Physiological Metrics Monitoring===
| |
| − | * Blood Pressure
| |
| − | ===Recovery Reviews===
| |
| − | * Status of Surgeries, Procedures, Tests, Therapies, etc.
| |
| − | * Effectiveness or Treatments and Activities
| |
| − | * Effectiveness of recovery team
| |
| − | * Effectiveness of Protocols
| |
| − | * Appropriateness of Recovery Goals
| |
