Improved Support for Patients Between Visits
Healthier patients have fewer acute situations
Integrate Coached Self-CareTM into Your Practice
Medicare has established Chronic Care Management and Remote Patient Monitoring to provide better preventative care for patients with two or more chronic conditions. Carefree’s Coached Self-Care in an integrated geriatric chronic care solution that combines CCM, RPM and geriatric pharmacy services to improve patient health and reduce hospitalizations.
With Coached Self-Care, your practice provides better care with no investment in new staff or systems, ensuring the patient gets consistent and comprehensive care after they leave your office.
Outcomes from Coached Self-CareTM
Improve patient outcomes, raise staff job satisfaction and increase practice revenues
Improve Patient Health
Experienced geriatric nurse-coaches local to the patient extend care beyond your office. Coordinated communication keeps the patient on the plan you approve. These services help your patients make progress on the health plan you create, keeping them healthier between visits.
Raise Staff Satisfaction
Carefree staff and systems work at your direction to ensure that you and your practice are at the center of all patient care. Because our systems are designed to integrate into your EMR, you continue to work in the ways you are most comfortable. We handle documentation and communication tasks so you and your staff focus on high value work.
Dedicated outreach to your patients by trained staff using our communication components improves your MIPS scores. New opportunities to code against additional CPT codes help practices extend care between office visits and generate new revenues.
- Many physicians see Chronic Care Management as a reimbursement mechanism for care which is already being provided to the patient rather than a new care system to dramatically improve patient health.
- Often CCM services are primarily focused on coordination and communication, which can help but miss the opportunity for significant improvements in health.
- Coached Self-Care is different because it is an integrated, holistic care-delivery platform for geriatric chronic care, based upon building a relationship between the patient and their nurse-coach.
Carefree is focused on meeting the the unique needs of each patient. Our nurse coaches are made up of NPs and PAs who excel not only in clinical care, but also in coaching to help your patients achieve their health goals.
Dynamic Care Plans
The nurse coach combines your care plan with those from other specialists to provide a clear set of achievable goals upon which the patient and family caregivers can focus. These care plans are dynamically changed to have the biggest positive impact on patient health.
Coached Self-Care is designed around proven psychological principles to help the patient take the right actions. We identify the patient’s profile to allow the coach to use individualized approaches to overcome barriers and achieve goals.
Carefree provides all medications in dose-time pouches and our coaches help patients with adherence. A pharmacist is assigned to each patient and will provide Medication Therapy Management.
Enhanced Office Visits
Our coach prepares both you and the patient for each office visit, so that you can maximize the use of your medical expertise for effective clinical care. The coach implements changes to your care plan, discusses them with the patient, and provides you with updates.
Geriatric Care Platform
Carefree’s Geriatric Care Platform informs our coaches on state-of-the-art clinical treatment for chronic conditions. This helps the coach select which goals and behaviors upon which to focus for each patient ensuring the highest impact on their health.