How to identify high cost specialists and how to create a care coordination agreement
July 28, 2017
Written by Kristen Schuster, Practice Facilitator
The utilization reports are broken down in to several categories for your practice to reference. One of the areas is identifying high cost specialists. Your practice can use this information to create collaboration agreements.
What applies to the specialist in a care coordination agreement?
- Specialist agrees to refer patient back to primary care physician (PCP) if additional diagnosis arise
- Secondary referrals are communicated back to the PCP
- Notify PCP of no-shows and cancellations
- If a patient self-refers the specialist agrees to notify the PCP
- Identify a timeline to receive specialist reports
What applies to the PCP in a care coordination agreement?
- PCP will prepare patient for the reason of the referral
- Provide adequate and timely medical records to the specialist
- Indicate urgency of the referral
- Provide direct contact information for the referring provider
- Follow-up with patients that no-show or cancel
CPC+ does expect care coordination with a specialist. The utilization report makes it easy to identify the specialist providers that are seeing your patients the most. Aligning the care coordination agreements with the utilization reports will aid in reducing patient costs to the health care system. Please refer to CPC+ for examples of a care coordination agreement.
If you have any questions, or run into issues with any of the CPC+ objectives and would like help please use the “Leave a Reply” section below, or email Kristen Schuster directly with your questions or comments.