Beyond the Bottom Line: Unlocking the Hidden ROI of Chronic Care Management Software

Bhushan Vanjari
May 22, 2024
3:54 pm
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From anecdotal evidence-based healthcare practices to data-backed healthcare practices, chronic care management software is taking healthcare practices beyond clinics and hospitals.

This is one of the main reasons why the healthcare industry has one of the highest adoption rates of technology. The introduction of Electronic Health Records (EHR) has already streamlined the processes and brought data-based practices into clinical healthcare delivery.

Despite continuous efforts, the rising chronic conditions in the aging population have been burdening the healthcare industry. That is why the Centers for Medicare and Medicaid Services (CMS) introduced the Chronic Care Management programs in 2015. Ever since the adoption rate of chronic care management has been on a steep rise.

While 92% of healthcare organizations have some kind of CCM program in place, there are some healthcare organizations trying to incorporate a full-pledged CCM program into their practice.

But since the investment in initiating the program is significant, you must be wondering about the chronic care management software ROI (Return on Investment)?

So, let’s discuss the economic and financial aspects of chronic care management programs and how to measure ROI in CCM software.

Without further ado, let’s get started!

Key Metrics for Measuring ROI

The hidden benefits of CCM software will make it your one-stop solution for your chronic care management program. However, measuring the success of the program is essential in calculating the ROI of chronic care management software. Here are some key metrics for measuring ROI in CCM software:

1. Clinical Outcomes

The implementation of chronic care management software changes your healthcare practice from anecdotal evidence to data-backed evidence-based practice. But how does the CCM software do it?

This is one of the major and essential functions of chronic care management software: to collect clinical data from remote patient monitoring devices and push it to patients’ health records. Enabling healthcare providers to track improvements in patient health metrics like blood pressure, blood sugar levels, and medication adherence helps quantify patient engagement in CCM, which is essential for providing value-added care.

2. Cost Saving

The financial impact of choosing the right CCM solution is seen in the aftermath of the care delivery, which again contributes to measuring the return on investment of the chronic care management software. Moreover, one of the reasons for CMS to start the CCM program is to help both patients and providers to save costs on healthcare expenditure.

And some of the stats about CCM software prove that, for instance, clinicians have observed a 30% reduction in hospital readmissions, which is an essential factor in shifting the focus to providing better healthcare and an indication of the success of the CCM program. Other cost-saving ventures with choosing the right CCM solution that come into the picture are decreased emergency room visits and better preventive care.

3. Operational Efficiency

Chronic care management software is useful not only for streamlining virtual care and better management of chronic conditions but also for increasing the efficiency of the clinic. That is why significant importance is given to clinical workflow integrating with the CCM software.

But how to measure ROI in CCM software for operational efficiency?

Well, since the software comes with features to streamline and automate clinical workflows, it reduces around 35% of clinicians’ time on documents. This alone improves the workflow of the clinic and takes a huge burden off of the administrative staff, leading to increased provider productivity. This increased provider productivity and operational efficiency is a crucial factor in measuring the return on investment for CCM software.

4. Patient Satisfaction

Access to educational material in CCM software for patient empowerment has become a growing demand from healthcare providers who are starting a chronic care management program. Giving patients more control of their health with easy access to features like appointment scheduling, EMR, real-time communication channels, telehealth platform integrations, etc., has brought the future trend in patient engagement in CCM very easy and quantifiable.

Due to this, you can easily track the progress patients have made with their satisfaction levels with care. This instills the human touch in providing virtual care and elevates the overall experience of the patient with the CCM software.

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5. Revenue Generation

Most of the clinics starting the CCM program look towards it as an opportunity to increase revenue generation from the clinical practice. By streamlining the billing processes, the chronic care management software even takes care of them by providing increased reimbursement opportunities.

However, revenue generation is one of the long-term ROI of CCMS as it bridges the gaps between care delivery. This is because you might start the program on a small patient population, but as the patient population increases, the opportunities for revenue generation also increase the financial impact of CCM software.

Data Collection & Analysis Strategies for Maximum ROI

The hidden benefits of CCM software can be used to predict and plan care delivery for maximizing return on investment. This is where you can leverage the existing data sources in the chronic care management software, such as EHRs and reimbursement claims submission data. By evaluating the successful claims being filed, you can easily predict the reimbursement and prepare a roadmap accordingly.

However, to calculate the ROI with CCM software, you should establish the baseline metrics before its implementation. The checklist mentioned above can give you a head start in this process. Since the focus should be on providing better care to chronic patients, that would be your return on investment with CCM software.

That is why it is crucial for you to introduce data visualization tools and techniques for better analysis and interpretation of results. This will not only make the diagnosis process faster but also easier to interpret, significantly contributing to improving patient health.

Along with that, the data collected by the ongoing process of data collection and continuous improvement will give long-term ROI of CCMS, as it will help develop a stable and scalable roadmap for the future.

Holistic Approach to ROI Evaluation

Though the information mentioned above would give you a brief idea about the ROI, how to measure ROI in CCM software in a holistic manner?

Let’s find that out below:

Combine Qualitative and Quantitative Data: The best way to get an estimation of return on investment with the CCM software is to combine qualitative and quantitative data. This means considering the qualitative data of the CCM software that elevates clinical practices like staff experience, patient feedback, etc. After this, check for improvements in numeric metrics with the implementation of CCM software. Here, factors like reduction in hospital readmissions, emergency visits, and claims denials.

Analyze Long-Term Impact: The financial impact of CCM software is significant in terms of initial investment. However, the long-term ROI of CCMS goes beyond the short-term financial gains of a reduction in errors in filing claims. For long-term benefits, it results in improving health outcomes and patient satisfaction levels and reduces the burden on healthcare staff.

Customize Your Evaluation: Though there are certain standard metrics to calculate chronic care management software ROI, it is important to realize that your healthcare organization is different from that of others. Due to this, some of the ROI metrics may not be important for your practice. For a holistic view of ROI evaluation in your practice, align the metrics with your clinic’s specific goals and priorities. Some of the essential factors to consider in this are patient populations, practice size, and software features.

Addressing Concerns and Challenges

Searching for the ideal chronic care management software for your practice might have given you the idea that it’s not easy to implement CCM software in your practice. The story with chronic care management software ROI is also quite similar. The upfront cost of the CCM software implementation is a major concern for small-scale practice along with its implementation hurdles like quantifying patient engagement in CCM, measuring clinical outcomes with CCM, etc.

However, with proper planning and a strategic approach, you can easily overcome these challenges and maximize the ROI with CCM software. For instance, the priority of the CCM software should be to streamline processes and play a transiting role in care delivery. Since the CCM software deals primarily with healthcare data, it is important to get the necessary compliances to ensure data security.

Conclusion

A data-driven approach is a crucial factor that shifts the focus from anecdote-evidence-based practices to data-based practices. With the CCM software, you improve the overall accuracy of care delivery, leading to faster and better patient outcomes, and this is actually the major return on investment for your CCM software.

However, if you are looking to implement CCM software with your practice, then you should consider the long-term ROI of CCMS. This way, you can not only generate patient trust but also attract a huge patient population. Still confused about chronic care management ROI? Then click here and book a call for your practice-specific detailed ROI analysis.

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Frequently Asked Question’s

1. How can healthcare organizations accurately measure the ROI of chronic care management software implementations?

Here is a step-by-step guide to help you measure chronic care management ROI:

Define Your Goals and Metrics
Financial Benefits
Patient Care Benefits
Track and Refine

2. What are the key metrics used to assess the success of chronic care management software?

Chronic care management software success can be assessed on the basis of patient engagement, clinical outcomes, care cost reduction, and care team efficiency.

3. What challenges do healthcare organizations face in evaluating ROI, and how can they overcome them?

Healthcare organizations face challenges when evaluating return on investment (ROI) due to several reasons:

Data quality and availability are often inconsistent.
It can be difficult to isolate the impact of specific investments.
Healthcare outcomes often have a long-term nature.
There is a lack of industry-standard ROI metrics.

To address these challenges, healthcare organizations should focus on standardizing their data, tracking both financial and clinical metrics, and collaborating with other organizations to establish benchmarks.

4. Can you provide examples of successful ROI evaluation in chronic care management software implementations?

Studies have shown successful ROI evaluation in chronic care management software implementations by:

Reduced hospital readmissions: Tracking readmission rates before and after software implementation.
Improved medication adherence: Monitoring prescription refill rates and patient outcomes.
Enhanced patient engagement: Assessing patient satisfaction, portal usage, and self-management behaviors.
Cost savings: Comparing direct healthcare costs (e.g., ER visits) against software investment.

5. What are the long-term benefits of accurately measuring ROI in healthcare technology investments?

Accurately measuring ROI in healthcare tech empowers informed, long-term decisions. It fosters efficient budget allocation, prioritizes impactful solutions, and drives continuous improvement in the value delivered by technology investments. This translates to better patient care, optimized resource use, and sustainable healthcare innovation.