For most practices, offering this service in-house is not financially viable due to the staffing, technology, and oversight required.
Staffing
A typical Care Coordinator requires about 500 patients “under management” to offset the salary and overhead costs associated with providing the service. Fewer patients under management means the practice is operating at a loss. Likewise, 600 patients under management means 100 patients either cannot be helped, or the practice has to hire another person (at a loss) to accommodate those patients. A practice may elect to split a technician’s time between care management and normal duties. This can be ineffective largely because patients require assistance at unpredictable times, or are unreachable when the Care Coordinator is free to contact them. The result is an inefficient process that is difficult to justify financially, frustrating for patients, and likely detrimental to the quality of care.
Lumata Health makes this work by managing patients for practices all over the country, keeping our Care Coordinators operating at close to 100% capacity across multiple locations and having a team of Care Coordinators available to answer patient calls at any time. Also, our Care Coordinators have a unique skill set – combining their eye care knowledge as a COA or COT with social work and behavioral science knowledge through our training programs.
Technology
Most practice EMRs are not equipped for care management. They lack specific functionality such as detailed and integrated time-tracking, automated call scheduling, embedded text messaging, automated care plan creation and many more features necessary to operate a successful care management program that satisfies CMS requirements. Lumata Health has invested heavily in building a custom, HIPAA-compliant platform specifically tailored for care management.
Lastly, our proprietary AI-driven engagement algorithms, built with NEI support, provide a level of efficiency and effectiveness that is difficult to replicate in-house.