If you’ve ever considered implementing a chronic care management (CCM) program at your healthcare facility, you probably have a few questions, the biggest one being whether only Medicare patients qualify for the program. The answer is no, but Medicare chronic care management programs may have specific parameters that set them apart from others.
Chronic Care Management and Medicare
Chronic care management through the CMS (Centers for Medicare and Medicaid Services) provides care to patients with at least two chronic conditions that are expected to last for at least 12 months. Patients with these conditions have a higher chance of acute exacerbation, decompensation, decline in health, and even death. Because these patients have serious health concerns, they need continuous care to ensure they have what they need to treat their conditions. CCM programs were created in response to these challenges.
The CMS requires healthcare providers to connect with patients who participate in the CCM program for at least 20 minutes a month. These meetings do not necessarily have to take place in person. They must, however, occur outside of normal office visits. Examples of care you will provide through the CMS CCM program are:
- 24/7 patient access to their care team
- Creation of a chronic care management care plan
- Regular follow-ups to check in on the patients’ health status
- Education on what steps patients can take to maintain a healthy lifestyle with their conditions
- Medication management to ensure patients are taking the right dosage to treat their conditions
- Remote monitoring so that the care team can track patients’ vital signs when they’re not in the office
What Does Medicare Pay for CCM?
The amount that Medicare reimburses your healthcare facility for your CCM program will vary depending on several factors, such as:
- Type of service
- Legislative updates
- Your facility’s location
As for how much Medicare will pay for a patient’s CCM bill, they will pay 80% if patients have Medicare Part B. Medicare may cover the entire cost of service for patients with both Medicare and Medicaid. How much they pay for patients with a Medicare Advantage plan will vary.
Supplement Your CCM Program With TimeDoc Health
TimeDoc Health provides the necessary platform and services for you to run a successful CCM program—particularly one for Medicare patients. In addition to providing trained care coordinators to work alongside your care teams, we also offer a platform that easily integrates with the tech systems you already use on a daily basis, such as the EHR. What’s more, we can assist both you and your patients with scheduling appointments, medication reconciliation, durable medical equipment assistance, and so much more.
To learn more about how we can supplement your CCM program, schedule a demo.