CipherHealth Improves Platform to Enhance Transitional Care Management

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Responding to the growing delivery of transitional care management incentivized by the Affordable Care Act, CipherHealth met the needs of their customers, providing a scalable workflow for transitional care management and efficient data gathering.

Preventable readmissions cost Medicare an estimated $17 billion a year

CipherHealth has added features and services to its Voice post-discharge triage and patient engagement platform serving U.S. hospitals nationwide. Meeting the growing demand from providers to perform transitional care management processes outlined in the Affordable Care Act, CipherHealth is giving healthcare providers an efficient way to perform and document the processes required in order to capitalize on Medicare incentives and avoid readmission penalties.

Preventable readmissions cost Medicare an estimated $17 billion a year, a cost Medicare has tried to combat by incentivizing hospitals to lower readmissions with reimbursement penalties. Because the likelihood for a patient to readmit is highest within the first five days of discharge, Medicare has implemented reimbursement codes for the practice of Transitional Care Management (or TCM, for short). Zach Silverzweig, Co-founder and head of product development at CipherHealth, commented, “The turnkey workflow solution we offer clients meets all of the considerations and operational rules for Transitional Care Management. What we provide streamlines the collection of data to increase reimbursement for these services, all while addressing the clinical needs of patients.”

What is TCM?
TCM refers to the care given to patients during their transitions from hospital to home and varies depending on their chronic or acute illnesses. To meet requirements for reimbursement, a provider must communicate with the patient, his or her family, or caregiver within 48 hours after discharge to identify patient issues, perform medication reconciliation, and/or confirm a follow-up encounter. The proactive post-discharge follow-up calls performed by CipherHealth’s Voice platform engage with entire populations to triage qualifying TCM patients and trigger alerts for additional follow up from clinical staff. The program works to reduce readmissions by upwards of 30% as well as schedule billable follow-up encounters. With streamlined data collection throughout this critical first step, information is shared across the provider system ensuring that TCM activities for each patient are appropriately documented to support the reimbursement process.

About CipherHealth:
CipherHealth is a New York City-based company founded in 2009 focused on creating solutions that help care providers effectively and efficiently provide quality care for their patients. CipherHealth leverages technology to make communication between care providers and patients easier, engaging, and more meaningful. For more information, please visit http://www.cipherhealth.com.

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Katharine Walker

Alyssa Kleinman