CHRONIC CARE MANAGMENT

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With chronic conditions on the rise and Medicare beneficiaries projected to grow significantly in the coming years, practices are turning to Chronic Care Management programs to improve patient outcomes and increase practice revenue. Here’s how your practice can evaluate a CCM program and decide whether to implement CCM.

It is predicted that the number of people in the United States with one or more chronic conditions is expected to grow from 141 million in 2010 to 171 million by 2030, which means that almost 1 in 2 Americans will suffer from a chronic disease in the not-so-distant future. In addition to a growing number of patients with chronic conditions, CMS statistics suggest that by 2030, total beneficiaries will be nearly 80 million in comparison to the 55.3 million people as of 2015 when the CCM code 99290 became available.

But before a practice makes the decision to implement a CCM program, it’s important to evaluate and understand the benefits and barriers to successful Chronic Care Management. 

What is Chronic Care Management?

In 2015, Medicare launched Chronic Care Management as part of the Connected Care initiative. Chronic care management is, according to CMS, care coordination services done outside of the regular office visit for patients with multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline. These services are typically non-face-to-face and allow eligible practitioners to bill for at least 20 minutes or more of care coordination services per month.

Chronic care management services may include:

  • At least 20 minutes a month of CCM services
  • Personalized assistance from a dedicated health care professional who works with patients to create a care plan
  • Coordination of care between the patient’s pharmacy, specialists, testing centers, hospitals, and more
  • 24/7 emergency access to a health care professional
  • Expert assistance with setting and meeting patient health goals

What are the Benefits of Chronic Care Management?

Care Management delivers a number of benefits to patients by addressing the challenges that exist when a patient has multiple chronic conditions. With CCM, patients can streamline care, avoid duplicate testing, reduce healthcare costs, and enhance the patient’s self-management skills.

For practices, CCM can bring in a new stream of revenue, improve patient engagement, and be an attractive differentiator compared to other practices not offering Chronic Care Management. According to a Quest Diagnostics survey, “Hidden Hazards: Closing the Care Gap Between Physicians and Patients with Multiple Chronic Conditions” physicians see a need for CCM with over 90% of physicians wishing they had help ensuring multiple chronic conditions (MCC) patients were adhering to their care plans and 85% stating they lacked the time to provide adequate care for MCC patients.

What are the Benefits of Chronic Care Management?

Care Management delivers a number of benefits to patients by addressing the challenges that exist when a patient has multiple chronic conditions. With CCM, patients can streamline care, avoid duplicate testing, reduce healthcare costs, and enhance the patient’s self-management skills.

For practices, CCM can bring in a new stream of revenue, improve patient engagement, and be an attractive differentiator compared to other practices not offering Chronic Care Management. According to a Quest Diagnostics survey, “Hidden Hazards: Closing the Care Gap Between Physicians and Patients with Multiple Chronic Conditions” physicians see a need for CCM with over 90% of physicians wishing they had help ensuring multiple chronic conditions (MCC) patients were adhering to their care plans and 85% stating they lacked the time to provide adequate care for MCC patients.