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The company's care coordination software and analytics allow providers achieve better care metrics
There's been a major shift in recent years toward value-based care; these are programs in which providers are paid based on the quality of care they provide, rather than simply for providing care no matter the outcome.
These types of programs are on the rise: in 2020, more than 40% of US healthcare payments stemmed from value-based reimbursement models. Yet, Medicare’s value-based care programs can be complex to interpret and difficult to implement for healthcare providers, said Dan Godla, founder and CEO of ThoroughCare.
The company, which provides care coordination software that helps physicians deliver value-based care, announced a $3 million round of funding from Cypress Growth Capital earlier this week.
“Value-based care programs tie provider compensation to performance metrics to enhance care quality. In these models, providers find they could miss reimbursement opportunities if they don’t meet the benchmarks required,” he said.
“We felt there was an opportunity to develop digital solutions that intuitively helped providers implement these programs in an automated fashion, and achieve objectives pertaining to patient engagement, improving outcomes, and maximizing reimbursements.”
ThoroughCare solves this problem by offering providers its care coordination software, along with mobile and analytics applications, so they have access to data that allows them to raise quality scores across categories, as well as earn Medicare payment incentives by measuring performance against value-based care metrics.
The company's software is utilized by physician practices and groups, rural health clinics, and accountable care organizations, who provide primary care services to Medicare patients; it aligns with Medicare’s value-based care programs, including Chronic Care Management, Annual Wellness Visits, Behavioral Health Integration, Remote Patient Monitoring, and Transitional Care Management.
ThoroughCare's customers are able to use the software to develop care plans for personalized care; connect patients and care teams digitally for better engagement and outcomes; analyze patient vitals and data through remote device integration; monitor trends and use insights to inform care decisions; track and log services provided; and accurately bill and submit claims to capitalize on Medicare reimbursement and revenue opportunity.
"These applications enable care teams to customize care plans, monitor vitals, coordinate care between providers, and document patient interactions. Administrators can accurately bill with CPT codes assigned to claims, based on time spent with each patient and maximize associated Medicare reimbursement," said Godla.
"With ThoroughCare’s Analytics application, care teams have visibility to clinical, operational, and financial data across multiple sites and large patient populations, in real-time."
ThoroughCare currently works with over 600 health clinics and physician practices across the country, and the company will use its new capital to build out its sales and marketing organization, as well as to enhance its product; that includes building out support for additional programs and integrating with new EHRs and software companies. On top of that, it will also be expanding into new markets.
"We’ve done very well with smaller clinics and provider groups. We look to expand our reach into larger provider groups, accountable care organizations, and health systems. Even the larger organizations struggle with implementing value-based care strategies across their patient population," said Godla.
All of this is in service of the company's larger goal: to prove that care management doesn’t need to be complicated.
"When done correctly, and with the right software, providers can achieve their value-based care goals while their patients are healthier. As a company, we strive to be the most knowledgeable resource in the industry for care management and wellness solutions."
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