Chronic Care Management: Benefits for Patients

Federal data reveals that at least two-thirds of Medicare enrollees have two or more chronic health conditions. This makes them eligible for the CCM program, which has shown promise in reducing emergency room visits, in-patient hospital stays, and overall health spending. 

Even more, medicare reimburses doctors approximately $62 per patient per month for 20 minutes of work under the CCM program. This payment covers the development of a patient care plan, coordination of treatment with specialists, and regular check-ins with beneficiaries. Without CCM, providers often lack the incentive to spend time on care coordination as it is not billable under traditional Medicare.

Benefits to Patients and Practices

The CCM program offers several key benefits to patients:

1. Reduced Emergency Room Visits: Regular check-ins and coordinated care help prevent unnecessary emergency room visits.
2. Fewer In-Patient Hospital Stays: Proactive management of chronic conditions leads to fewer hospital admissions.
3. Improved Health Outcomes: Continuous monitoring and timely interventions result in better overall health for patients.
4. Increased Reassurance: Patients receive regular check-ins, which provide reassurance and help manage their conditions effectively.
5. Enhanced Care Coordination: Development of a personalized care plan and coordination with specialists ensure comprehensive and cohesive care.
6. Support for Medication Management: Assistance with medication adherence reduces the risk of complications related to missed doses.

Dr. Jennifer Bacani McKenney, who runs a family medicine practice in Fredonia, Kansas, with her father, highlights the program's value. For Carrie Lester, a patient in their practice, the regular check-ins have helped reduce unnecessary emergency room visits and provide a sense of reassurance.

McKenney's practice employs a medical assistant who regularly calls patients to check on their health, something the practice couldn't afford before CCM funding. This proactive approach has been especially beneficial for patients prone to emergency room visits for non-emergency reasons, such as running out of medication or feeling lonely.

Outsourcing as a Solution

Some healthcare systems have turned to outsourcing to manage the CCM program. UnityPoint Health, for instance, found it administratively burdensome to handle CCM in-house and now contracts with HealthSnap, a Miami-based company. HealthSnap helps enroll patients, conducts monthly check-ins, and assists with billing, making the program more manageable for UnityPoint Health's extensive Medicare patient base.

The Future of Chronic Care Management

The CCM program continues to provide essential support to patients with multiple chronic conditions. By reducing hospital visits and improving the overall quality of care, CCM helps patients lead healthier, more stable lives. For healthcare providers, it offers a way to enhance patient care and increase practice revenue, despite the challenges of implementation.

With continued adjustments and support, the CCM program can expand its reach and further demonstrate its value, potentially transforming the management of chronic conditions for Medicare enrollees across the country.

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