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{"sheet":"Instructions","index":0,"n_rows":19,"n_cols":5,"rows_kept":19,"cut":false,"hidden":false,"merged":[[0,1,0,4],[1,1,1,4],[18,1,18,4],[7,3,9,3]]}
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[null,"This calculator provides an analysis of the business case for adding clinical staff to increase capacity for wellness care and chronic care management, or to estimate revenues that may be available from increasing these services using existing staff.  The calculator considers traditional Medicare patients and payments only; Medicare Advantage and some commercial insurers may also pay for these or similar services.  These are only estimates, and your particular results may vary."]
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[null,null,null,"←","Green cells contain intermediate calculations for estimating costs and revenues."]
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[null,null,null,"←","Values in orange cells can be changed by you."]
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[null,null,0.1]
[null,null,0.1,null,"The percentages in these cells should add to 100%"]
[null,null,0.8]
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[null,null,null,"←","Hover cursor over cells with red corners for more information."]
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[null,null,null,"←","Click on this button to return the values in the orange cells to their initial values."]
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[null,null,null,"←","Click on this button to save the scenario.  The scenario will be saved as an image with the values fixed.  It will be inserted into a new worksheet in this workbook."]
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[null,"This material was prepared by Comagine Health, formerly HealthInsight, the Medicare Quality Innovation Network -Quality Improvement Organization for Nevada, New Mexico, Oregon and Utah, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents presented do not necessarily reflect CMS policy. "]

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[null,"YOUR HOSPITAL'S FEE-FOR-SERVICE MEDICARE DATA:"]
[]
[null,"HOSPITAL NAME"]
[]
[null,"Medicare FFS (Part B) Patients Attributed to Practice",null,null,null,0]
[]
[null,"Annual Wellness Visits",null,null,null,null,null,null,"Chronic Care Management",null,null,null,null,"Transitional Care Management"]
[null,"Visit Type",null,null,"Number",null,"%","% of Total","Chronic Care Management Service",null,null,"Number","Unique Pts","Transitional Care Management Service",null,null,null,"Number","Unique Pts"]
[null,"Any Type of Wellness Visit",null,null,{"$f":"E11+E12+E13","v":0},null,{"$f":"E10/$F$6","v":{"$error":"#DIV/0!"}},null,"20 Minutes  (99490)",null,null,0,0,"Moderate Complexity w/in 14 Days of Discharge (99495)",null,null,null,50,0]
[null,"Welcome to Medicare (G0402)",null,null,0,null,{"$f":"E11/$F$6","v":{"$error":"#DIV/0!"}},{"$f":"IF(E11=0,\"0%\",(E11/$E$10))","v":"0%"},"Complex - 60 Min. (99487)",null,null,0,0]
[null,"Initial AWV (G0438)",null,null,0,null,{"$f":"E12/$F$6","v":{"$error":"#DIV/0!"}},{"$f":"IF(E12=0,\"0%\",(E12/$E$10))","v":"0%"},"Complex - Addl. 30 Min. (99489)",null,null,0,0,"High Complexity w/in 7 Days of Discharge (99496)",null,null,null,50,0]
[null,"Subsequent AWV (G0439)",null,null,0,null,{"$f":"E13/$F$6","v":{"$error":"#DIV/0!"}},{"$f":"IF(E13=0,\"0%\",(E13/$E$10))","v":"0%"}]
[]
[null,"ESTIMATED TOTAL MEDICARE PAYMENT",null,null,null,null,null,{"$f":"(E11*J29)+(E12*J30)+(E13*J31)","v":0},null,null,null,null,{"$f":"(L10*J40)+(L11*J41)+(L12*J42)","v":0},null,null,null,null,null,{"$f":"(R10*J49)+(R12*J50)","v":20178}]
[]
[null,null,null,null,null,null,null,null,null,null,"ESTIMATED TOTAL MEDICARE PAYMENT FOR ALL SERVICES (AWVs, CCM and TCM) COMBINED",null,null,null,null,null,null,null,{"$f":"SUM(H15,M15,S15)","v":20178}]
[]
[]
[null,"BUSINESS CASE CALCULATOR:"]
[]
[null,"Medicare FFS Population",null,null,500,null,"Distribution of Service Types","Participation Count","Annual Total","2018 National Fee3","Annual Revenues","Provider Time4 (minutes/unit)","Clinical Staff Time4 (minutes/unit)","Annual Provider Time (hours)","Annual Clinical Staff Time\n(hours)","Total Annual Clinical Staff and Provider Cost",null,"Net Revenue"]
[null,"Clinical Staff1 Cost - Fully Loaded /Hour",null,null,55]
[null,"Provider2 Cost - Fully Loaded /Hour",null,null,165]
[]
[null,"ANNUAL WELLNESS VISITS"]
[null,"Wellness Care - Overall Participation",null,null,null,null,0.7,{"$f":"ROUND(G27*E22,0)","v":350}]
[]
[null,"Welcome to Medicare (G0402)",null,null,null,null,0.1,{"$f":"ROUND((E22*G27*G29),0)","v":35},{"$f":"H29","v":35},169.92,{"$f":"J29*I29","v":5947.2},30,60,{"$f":"(L29/60)*I29","v":17.5},{"$f":"(I29/60)*M29","v":35},{"$f":"(O29*E$23)+(N29*E$24)","v":4812.5}]
[null,"Initial AWV (G0438)",null,null,null,null,0.1,{"$f":"ROUND((E22*G27*G30),0)","v":35},{"$f":"H30","v":35},175.32,{"$f":"J30*I30","v":6136.2},25,70,{"$f":"(L30/60)*I30","v":14.583333333333334},{"$f":"(I30/60)*M30","v":40.833333333333336},{"$f":"(O30*E$23)+(N30*E$24)","v":4652.0833333333339}]
[null,"Subsequent AWV (G0439)",null,null,null,null,0.8,{"$f":"ROUND((E22*G27*G31),0)","v":280},{"$f":"H31","v":280},119.16,{"$f":"J31*I31","v":33364.799999999996},20,60,{"$f":"(L31/60)*I31","v":93.333333333333329},{"$f":"(I31/60)*M31","v":280},{"$f":"(O31*E$23)+(N31*E$24)","v":30800}]
[]
[null,null,null,null,"TOTAL",null,null,null,null,{"$f":"SUM(K29:K31)","v":45448.2},null,null,null,null,{"$f":"SUM(P29:P31)","v":40264.583333333336},null,null,{"$f":"J33-O33","v":5183.6166666666613}]
[]
[null,"CHRONIC CARE MANAGEMENT  "]
[null,"Patients Eligible for Chronic Care Management",null,null,null,null,0.3,{"$f":"ROUND(G36*E22,0)","v":150}]
[null,"Patients Eligible for CCM Who Participate",null,null,null,null,0.5,{"$f":"ROUND(G36*G37*E22,0)","v":75}]
[]
[null,"Monthly:","Eligible Pts Receiving CCM (any type) ",null,null,null,0.25,{"$f":"ROUND(H37*G39,0)","v":19}]
[null,null,"CCM - 20 Minutes (99490)",null,null,null,0.7,{"$f":"ROUND(H39*G40,0)","v":13},{"$f":"H40*12","v":156},42.84,{"$f":"J40*I40","v":6683.0400000000009},5,20,{"$f":"(L40/60)*I40","v":13},{"$f":"(I40/60)*M40","v":52},{"$f":"(O40*E$23)+(N40*E$24)","v":5005}]
[null,null,"CCM - Complex; 60 minutes (99487)",null,null,null,0.3,{"$f":"ROUND(H39*G41,0)","v":6},{"$f":"H41*12","v":72},94.68,{"$f":"J41*I41","v":6816.9600000000009},15,50,{"$f":"(L41/60)*I41","v":18},{"$f":"(I41/60)*M41","v":60},{"$f":"(O41*E$23)+(N41*E$24)","v":6270}]
[null,null,"CCM - Complex; Addl. 30 Minutes(99489)",null,null,null,0.05,{"$f":"ROUND(H39*G42,0)","v":1},{"$f":"H42*12","v":12},47.16,{"$f":"J42*I42","v":565.91999999999996},10,25,{"$f":"(L42/60)*I42","v":2},{"$f":"(I42/60)*M42","v":5},{"$f":"(O42*E$23)+(N42*E$24)","v":605}]
[]
[null,null,null,null,"TOTAL",null,null,null,null,{"$f":"SUM(K40:K42)","v":14065.920000000002},null,null,null,null,{"$f":"SUM(P40:P42)","v":11880},null,null,{"$f":"J44-O44","v":2185.9200000000019}]
[]
[null,"TRANSITONAL CARE MANAGEMENT"]
[null,"Patients w/ Eligible Discharges per Year",null,null,null,null,0.15,{"$f":"ROUND(E22*G47,0)","v":75}]
[null,"Patients w/ Eligible Discharges Who Participate",null,null,null,null,0.5,{"$f":"ROUND(G48*H47,0)","v":38}]
[null,"TCM - Mod. Complexity w/in 14 Days of Discharge (99495)",null,null,null,null,0.5,{"$f":"ROUND((E$22*G$47*G$48*G49),0)","v":19},{"$f":"H49","v":19},167.04,{"$f":"I49*J49","v":3173.7599999999998},40,45,{"$f":"(L49/60)*I49","v":12.666666666666666},{"$f":"(M49/60)*I49","v":14.25},{"$f":"(O49*E$23)+(N49*E$24)","v":2873.75}]
[null,"TCM - High Complexity w/in 7 Days of Discharge (99496)",null,null,null,null,0.5,{"$f":"ROUND((E$22*G$47*G$48*G50),0)","v":19},{"$f":"H50","v":19},236.52,{"$f":"I50*J50","v":4493.88},50,60,{"$f":"(L50/60)*I50","v":15.833333333333334},{"$f":"(M50/60)*I50","v":19},{"$f":"(O50*E$23)+(N50*E$24)","v":3657.5}]
[]
[null,null,null,null,"TOTAL",null,null,null,null,{"$f":"SUM(K49:K50)","v":7667.6399999999994},null,null,null,null,{"$f":"SUM(P49:P50)","v":6531.25},null,null,{"$f":"J52-O52","v":1136.3899999999994}]
[]
[]
[null,"ALL SERVICES (AWV, CCM and TCM) COMBINED5",null,null,null,null,null,null,null,null,{"$f":"SUM(J33,J44,J52)","v":67181.759999999995},null,null,null,null,{"$f":"SUM(O33,O44,O52)","v":58675.833333333336},null,{"$f":"SUM(R33,R44,R52)","v":8505.9266666666626}]
[]
[]
[null,"Notes:"]
[null,"1","Clinical staff includes RN's, MA's, care managers and similar staff."]
[null,"2","Providers include MD's, DO's, NP's and PA's"]
[null,3,"Actual Medicare payment includes geographic adjustment."]
[null,4,"Estimates of provider and staff time for services are based on Medicare requirements, literature review, input from subject matter experts and analysis of task requirements."]
[null,5,"Practices may realize additional revenues from preventive services, immunizations, advance care planning, chronic care plan development, and prolonged non-face-to-face services.  Does not include incentives and bonuses that may be earned under value-based payment programs. "]

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[null,null,null,"Distribution of Service Types","Provider Time\n (minutes/unit)","Clinical Staff Time (minutes/unit)"]
[null,"Clinical Staff Cost - Fully Loaded, per Hour",55]
[null,"Provider Cost - Fully Loaded, per Hour",165]
[null,"ANNUAL WELLNESS VISITS"]
[null,"Wellness care - Overall Participation",null,0.7]
[]
[null,"Welcome to Medicare (G0402))",null,0.1,30,60]
[null,"Initial AWV (G0438)",null,0.1,25,70]
[null,"Subsequent AWV (G0439)",null,0.8,20,60]
[null,"CHRONIC CARE MANAGEMENT  "]
[null,"% of Patients Eligible",null,0.3]
[null,"% of Eligible Patients Who Participate",null,0.5]
[null,"Eligible Pts Receiving CCM (any type) ",null,0.25]
[null,"CCM - 20 Minutes (99490)",null,0.7,5,20]
[null,"CCM - Complex; 60 minutes (99487)",null,0.3,15,50]
[null,"CCM - Complex; Addl. 30 Minutes(99489)",null,0.05,10,25]
[]
[null,"TRANSITONAL CARE MANAGEMENT"]
[null,"% of Patients w/ Eligible Discharges per Year",null,0.15]
[null,"% of Eligible Patients Who Participate",null,0.5]
[null,"TCM - Moderate Complexity w/in 14 Days of Discharge (99495)",null,0.5,40,45]
[null,"TCM - High Complexity w/in 7 Days of Discharge (99496)",null,0.5,50,60]