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Understanding Chronic Care Management and Its Importance

Chronic care management (CCM) continues to be a point of discussion in the healthcare industry as more providers are showing interest in implementing CCM into their practice. More than 133 million US citizens suffer from a chronic disease, which results in 85% of the countries healthcare expenses going towards the treatment of those diseases. Those numbers compel medical facilities and healthcare professionals to invest in CCM to help patients lead more comfortable lives despite what ails them.

What is Chronic Care Management?

Chronic Care Management is defined as non-face-to-face visits provided to Medicare beneficiaries who have multiple chronic conditions. The kind of services involved in CCM centers around a couple of areas, such as:

  • Effective communication with patients
  • Coordination with other care providers
  • Management of prescriptions and resources for patients
  • Increased access to care for chronically ill patients outside of regular practice hours

Basically, CCM combines educational activities and professional healthcare oversights to help patients better deal with their chronic diseases. This kind of care and treatment builds better relationships with patients and providers due to increased communication and oversight.

Importance of Chronic Care Management

CCM was first introduced in 2015 by the Centers for Medicare & Medicaid Services (CMS). They created a reimbursement program that allows providers to get paid for offering CCM services. This allows providers to effectively incorporate CCM into their practice but also lowers the cause of healthcare for patients under CCM. All in all, CCM makes healthcare much more accessible for patients. Some of the benefits of CCM are:

  • Care Coordination

A problem that has plagued chronically ill patients for decades is the lack of organization with their care. As chronic diseases tend to be more complex, especially for patients suffering from multiple ailments, they often require help from many different providers. Those providers target only specific issues that may or may not be connected with the other symptoms and conditions. This creates confusion, costly mistakes, and misdiagnosis. Chronic care management eliminates all this through care coordination by making sure a care team is always in place to help them with their medical needs.

  • New Stream of Revenue

With the advent of CCM also comes a new stream of revenue for several practices. Because of the reimbursements and payments that providers receive for offering CCM services, they get a lot more financial gain than continuing their practice without CCM. Since CCM requires the coordination of several care providers, some practices may already have qualified individuals, which lessens the cost of hiring new people for the newly created care teams. Finally, it also brings in more patients because of the elevated quality of care that the providers are now able to give.

  • Improved Quality of Life

Patients battling chronic conditions now have a better chance of living better lives with the help of a dedicated care team that understands the totality of their symptoms. Studies have shown that CCM services have helped decrease depression, increase social activity, and promote patient engagement for these individuals. These patients feel that they have personal advocates for their health that are always there to support them. Patients’ questions are being answered, medication contradictions are being avoided, and patients are given an improved quality of life as long as they need it.

Conclusion

Chronic care management has proven to be beneficial to both patients and providers. Ever since its implementation, it has been helping many chronically ill patients live better lives under a dedicated care team’s oversight.

Medistics Health is at the forefront of medical innovation by giving patients a more accessible level of care. We work with patients and providers through our remote patient monitoring system and developing person-centered care plans with them. From chronic care management to behavioral health treatment, Medistics Health is here to simplify their experience. 

Profit Calculator Assumptions: 40% of total Medicare patients enrolling is based on (i) Medicare Chart Book’s data showing that ~68% of medicare patients qualify for CCM (2 or more chronic conditions), and (ii) that ~40% of eligible patients will enroll.

For typical providers, $46.67 of net profit per patient per month is based on a Medicare reimbursement per patient per month (national average) for various care management CPT codes.

CPT and other codes, descriptions and other data are copyright 2011 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).