Chronic Care Management Introduction (for Providers)| CCM Pays

To Discover if CCM is right for your practice: • Is Chronic Care Manage...
Chronic Care Management is a Medicare program available to patients with two or more chronic medical conditions which could exacerbate or cause patient decline within 12 months. It provides increased disease monitoring and medical care through monthly contact between the medical provider and the patient. It has been found to reduce overall Medicare costs for patients, mainly from decreased hospitalization and use of skilled nursing facilities.
You know this experience if you practice primary care and are conscientious about managing your patients’ chronic illnesses. There just doesn’t seem to be enough time to click all the boxes on the computer to order labs, adjust medicines, review treatment goals, and still address patient concerns.
Now there is way to get paid by Medicare for having your Medical Assistant or nurse set all of these things up for you by checking in with patient’s chronic conditions monthly over the phone. You only have to review and sign orders based on condition-specific templates followed by your staff. That is what Chronic Care Management does.
Chronic Care Management is a Medicare program intended to improve the health of the patients who need the most healthcare, patients with chronic disease. It’s available to patients with two or more chronic illnesses. It pays providers around $43 if they and their clinical staff spend 20 minutes or more working with the patient’s care in a given month. And it is intended to be done monthly.
When it is done correctly, nearly all of the routine box-checking related to chronic care management is done over the phone. This frees up both the provider and the patient to spend in-office visits reviewing periodic condition-specific exams and addressing the patient’s other health concerns. This improves patient satisfaction, because these other concerns are usually more important to the patient than their chronic illness. It helps to adjust the patient’s care plan with monthly frequency to accelerate achieving mutually created goals for the patients health. It also catches new problems when they occur without waiting until the next in-office appointment to start a work up or adjust medication.
It almost sounds too good to be true. Medicare paying primary care providers monthly to keep patients in good health. It’s getting paid for providing the kind of care we would all love to be able to afford to give our patients. It’s been found to be more than cost effective for Medicare too. A policy research study my Mathmatica published in 2017 found that at 18 months of implementation of CCM, Medicare was saving $74 per beneficiary per month on the program, even after paying $43 to the CCM provider. This money was mostly saved in the areas of inpatient hospital and skilled nursing facility expenses.
These patients are healthier!
Now there are some very specific Medicare rules which must be followed to do this correctly. For more details, watch our next video, “Is Chronic Care Management Right for My Practice?”