Creating a scalable model that brings concussion care to more patients

Recognizing the demand for quick and effective concussion care

Prior to the formation of MAC Alliance, Dr. Schaller was working in urgent care where he was seeing a number of patients come in with concussions that his practice was not prepared to manage. Because local schools were ImPACT baseline testing, there was a demand for ImPACT-trained providers to offer post-concussion care. Even though urgent care is well-positioned to be the go-to resource for post-concussion care because of its commitment to getting patients seen quickly and being a cheaper alternative to the emergency room, they were missing a huge opportunity by not having the concussion care tools or training to provide this much-needed service.

With this in mind, Dr. Schaller wanted to learn more about ImPACT and how to leverage it for his practice. In 2010, he completed the Credentialed ImPACT Consultant (CIC) program which is a rigorous training program that teaches clinicians how to offer best in class concussion care using ImPACT.

After completing this training, Dr. Schaller realized that the current concussion clinic model was not set up in a way that gives patients the best chance of successful recovery. Early access to post-concussion care is proven to factor into recovery, yet a neurologist may have an 8-12 week waiting list for new patients. Realizing this gap in providing concussion care, MAC Alliance was formed.

Creating a scalable and profitable concussion care business model

Because of the potential urgent cares have to be the go-to concussion care resource in their area, MAC Alliance wanted to get ImPACT into as many urgent cares as possible. Knowing that urgent cares’ biggest pain points are time and money, MAC Alliance came up with a creative solution for urgent cares to reap the benefits of offering ImPACT without changing the length of their evaluation or adding an additional cost.

The solution was having them do a 30-minute evaluation consisting of initial intake, medical history, VOMS, and assigning brain rest. Then, patients were asked to return the following day to complete ImPACT. From there, MAC Alliance’s group of CICs trained in the interpretation of ImPACT, read the clinical report remotely and call the patient the next day to explain the results and provide a recommendation if further treatment is needed.

Increasing patient volume and revenue through a strong referral network

To every patient whose clinical report is interpreted, MAC Alliance sends the online Concussion Care Providers directory where they can find ImPACT-trained concussion specialists in their area for follow up care. Even though this directory is not exclusively MAC providers, about 90% of patients who have taken ImPACT through one of their affiliates choose a MAC clinic for continued care. MAC Alliance has also been able to leverage reimbursement for using ImPACT as part of every evaluation - seeing up to $150 per visit.

“ImPACT has been our staple since the beginning. It’s clinically proven, tried and tested to fit our workflow, and increases revenue.”

MAC Alliance not only sees referrals for their own clinics, but for their urgent care affiliates as well. Since MAC Alliance has over 200 schools who are actively ImPACT baseline testing students, they are likely to come into an urgent care for post-concussion care. If the head injury is managed effectively, patients and athletic trainers will be inclined to return or refer to that clinic for other injuries as well.

“Urgent care is the perfect place for any head injury to start. ImPACT helps us offer urgent cares more business and a reputation of higher quality of care.”

Increasing access to specialized care with telemedicine

MAC Alliance realized that even with their extensive network of trained providers in both metropolitan and rural areas, there were still some patients who did not have easy access to specialized concussion treatment and rehab. To further increase patient access to care, they launched their telemedicine program and cared for approximately 20% of their patients via telemedicine.

A few years later, a global pandemic not only forced their in-person clinics to temporarily close, but also resulted in many providers being quarantined and not able to provide in-person care. At this point, MAC Alliance shifted to 100% telemedicine in a matter of days.

Even with patients and doctors at home, MAC Alliance was still able to get patients to complete ImPACT as part of every evaluation thanks to remote ImPACT post-injury testing via telemedicine. Not only was MAC Alliance able to quickly adapt, they also kept all existing patients on their recovery track and acquired new patients. MAC Alliance has even been able to continue training providers using ImPACT Applications’ video-on-demand credential programs and CE-eligible courses.

After seeing the telemedicine program in practice, Dr. Schaller’s initial concerns about whether a comprehensive telemedicine program was feasible were quickly put to rest as he realized he could still obtain the same clinical outcomes with telemedicine as he does in the clinic. While there are always cases that will require some level of in-person care, Dr. Schaller believes that 90% of MAC Alliance’s patients could be treated from start to finish via telemedicine without ever needing to be seen in the clinic. Since MAC Alliance has patients who often travel upwards of 4 hours to be seen, Dr. Schaller believes telemedicine will be more widely used going forward due to its ability to increase patient accessibility without compromising quality of care.