CarePaths is Hiring!

We are looking for the following:

1) Business manager—This is a full time position. Business background and some basic IT. Responsibilities will include basic business tasks e.g. accounting, payroll, HR, etc. Also, will oversee customer service support staff; assist project manager with IT projects; and contribute to marketing initiatives. Candidate can work remotely.

2) Programmer–We are looking for a full-time Ruby developer responsible for building Ruby applications, including anything from complex groups of back-end microservices to command line utilities and data processing scripts. Your primary responsibility will be to design and develop these applications, and to coordinate with the rest of the team working on different layers of the infrastructure. Thus, a commitment to collaborative problem solving, sophisticated design, and building quality products is essential.

Responsibilities:Design, build, and maintain efficient, reusable, and reliable Ruby code. Ensure the best possible performance, quality, and responsiveness of the applications. Identify bottlenecks and bugs, and devise solutions to these problems. Help maintain code quality, organization, and automation.

Skills
Good understanding of the syntax of Ruby and its nuances
Understanding of functional programming style in Ruby
Skills for writing reusable Ruby libraries that may be used in expressive ways
Familiarity with concepts of MVC, Mocking, ORM, and RESTful
Experience with popular web application frameworks (such as Rails, Lotus, etc)
Familiarity with command-suite libraries (such as Thor and GLI)
Experience with both external and embedded databases

Candidate can work remotely.

3) Statistician/Research Psychologist—This is a part time consulting position. CarePaths has a very large database of de-identified clinical, demographic, and utilization/cost information. Initial projects include: 1) developing case mix adjusted outcomes reports; 2) assessing the effectiveness of daily monitoring as a complement to weekly outcomes; 3) identifying factors associated with drop out from treatment. Candidate can work remotely.

Are Dropouts Crippling Your Practice?

Tony Rousmaniere, Psy.D., has described dropouts as the “invisible plague” of psychotherapy but as with many clinical issues, measurement is a problem. The dropout literature tries to identify patients who prematurely terminate but the operational definition of premature termination is quite varied. This literature does not help the practicing clinician determine if dropouts are a problem in his or her practice.

At Carepaths we are interested in how data and technology can help clinicians practice more effectively, so we decided to see if we could identify some dropout benchmarks in our data. We started with looking at patients who do not return after the initial session. We looked at patients whose first clinical service was a diagnostic evaluation (90791) in November 2016. Our sample included 1335 patients from 20 group practices. Drop out was defined as failure to attend a follow up appointment within 30 days of the index visit. 81.1% or about 4 in 5 patients return for a follow-up appointment.

This chart shows variance by clinician.

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If we assume 80% as a benchmark for dropout, we see that most clinicians, 75 of 105, or 71% meet or exceed the benchmark. About 29% (30 of 105) fall below the benchmark. These data directionally accord with a recent study that estimated that 12.6% of drop outs is due to therapist effects.

A takeaway from this analysis is that private practitioners as a group do a good job at engaging patients in therapy. These good results may in turn be due to the competitive pressures of clinical practice whereby therapists better at engaging patients survive.

In upcoming blogs we will be looking further at the patients who do not return. We plan to look at case mix to guauge the effect of patient age, gender and diagnosis. A lower benchmark may be appropriate for some patient populations. We are interested in tools to enhance engagement such as automated appointment reminders (e.g. are text reminders better than email reminders?) and the use of our mobile assessment and daily monitoring. We would also like to tease out the effect of cost on patients following up.

And finally, we are also interested in a benchmark for patients who dropout later in treatment. For this analysis, we can use the presence of a scheduled appointment and indication of the clinician’s judgement that more treatment is indicated.

New Features and Enhancements

We have added new features and enhancements that can save you time, simplify your practice, and increase your income.

Mobile—Cage-AID added to standard assessment package. This four question assessment screens for alcohol and substance abuse. It is very quick and has sound psychometric properties.

A new CPT code, 96127, can be used to bill for brief assessments. Many payers including Cigna, Anthem, Aetna, Humana, and Medicare reimburse quarterly for these assessments. Average reimbursement is $6 per instrument or $18 if you use our standard package of the PHQ 9, GAD 7 and Cage-AID.

We will be adding other instruments in the next few months as well as the ability for clinicians to choose among instrument(s)

Fax–You can download a pdf of a sent fax. If you put in the purpose of the disclosure in the comments section of the fax, you can comply with HIPAA requirements. Go to the fax log and click on the faxed document and it will download as a pdf, (includes cover sheet.)

Searching for inactive clients– All staff can now search for inactive client records to prevent duplicate records. When you click Add new patient, you will get a Patient duplicate search page. Put in your search criteria and click search. If you are an administrator of the site you will get a list of matching records if they exist. If you are a non-administrator you will get a message that possible duplicates exist. You will need to then check with an administrator on the possible matches. You can skip the search option.

New Reports–Last Target Service Reports allow you to create a list of all your patients with the date they were billed for a specific service or had a specific document completed. This is useful if you are required to complete a document. e.g. treatment pan, or are able to bill for a service, e.g. diagnostic assessment, at specific intervals.

Claims–We have a new way to review claims that makes it easier to find claims that need attention. When you go to claim in the organization or patient view, you’ll see claims, starting with the most recently submitted. Each line here represents a single patient visit that has
been submitted to one or more payer(s). The status of the claim appears on the right so you can see at a glance if a claim needs attention. Use the filter above the claims and select ‘User Action Required’ to see only the claims that need attention. Use the ‘Unadjudicated’ filter and set ‘Date Created’ to three months ago to see aging claims.

If a claim has been submitted more than once or submitted to a secondary payer, click ‘Submissions’ for detail on each submission. Click ‘Feedback’ for more detail on problem claims. You can also click ‘Batches’ at the top of the page to review the submissions in a
batch.

You can update a claim’s status. If you call a payer about a claim that had no payer feedback, you can update the status by clicking ‘Details’ under submissions and add notes about your call.