Nurse holding elder man hands for CCM services.

What Providers Should Know About Chronic Care Management

Chronic Care Management (CCM) Services were introduced by the Center for Medicare and Medicaid Services (CMS) in 2015 in an effort to aid patients battling multiple chronic conditions.

Since its implementation, it has greatly impacted the medical community by improving eligible patient’s access to important care, improve those patient’s outcomes, and help the practice achieve their financial goals. CCM services have changed care for the chronically ill, and are proving to better lives across the Nation. What does this mean for providers and their patients in 2023?

What is Chronic Care Management?

When CMS introduced Chronic Care Management in 2015, they began paying separately under the Medicare physician fee schedule for CCM services provided to eligible patients with two or more chronic conditions. It is defined by CMS as 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 places the patient at significant risk of death, acute exacerbation/decompensation, or function decline.

How Will it Impact Your Practice?

1) Introduce New Revenue

Providers have the potential to introduce an entirely new revenue stream into their practice by implementing Chronic Care Management. Through the reimbursement for services, providers can earn up to 85k per year per billing physician.

The main concern may providers have is that the cost of maintaining an in-house Chronic Care Management services would actually drain their resources instead of boosting their bottom line, and this can happen. The key to optimizing Chronic Care Management at your practice is to partner with a vendor of services, reducing your overhead cost while still offering valuable care to their eligible patients.

2) Bring in New Patients

The results of Chronic Care Management are proving themselves and patients want to reap the benefits. Patients who are juggling multiple physicians, multiple specialists and a long list of care maintenance are searching for providers who can offer them what they need.

By implementing Chronic Care Management, patients who are on the search for coordinated care will come to your practice for the help they need, increasing your patient base.

What Will it Benefit Your Patients?

1) Improved Outcomes

Care coordination services with Chronic Care Management are helping patients who have been struggling with their quality of life, and helping providers achieve improved health outcomes and improved symptoms management. The scattered components of their overall medical care are woven together so that information is communicated more effectively between physicians and specialists, clinical decision making is functioning at its best for all parties, and the patient gets the help they need to stay on top of their responsibilities. Through care coordination, the connection to community resources, and a heightened ability to stay on top of their care, patients see improved outcomes with Chronic Care Management.

2) Reduction in Hospitalizations

The introduction of Chronic Care Management into a patient’s medical care means catching red flags more effectively, leading to a decrease in hospitalizations. Open lines of communication, care coordination, and patient engagement enable for quicker intervention when problems present themselves. Without Chronic Care Managements, symptoms can get lost in the mess of their care and grow without being noticed by a treating provider. Through monthly phone calls and 24/7 access to qualified professionals, patients can bring up a new symptom for concern when it is happening, versus when it is too late.

The outsourcing of Chronic Care Management Services is the key to making sure your practice can offer these important services to its patients without sacrificing financial or physician resources. To learn more about how your practice can effectively offer Chronic Care Management, click here.



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