Chronic Care Management Services are delivered to Medicare beneficiaries with two or more chronic conditions with the goal of improving health and quality of care for high-need patients. As the population ages, FQHCs, RHCs, ACOs, hospitals, individual practitioners, etc. face the daunting challenge of improving the quality of care for chronically ill patients while containing costs.

The Centers for Medicare and Medicaid Services (CMS) say about 93% of total Medicare spending is on beneficiaries with multiple chronic conditions. Research has shown that highly fragmented care for Medicare beneficiaries with multiple chronic conditions is more likely to present in emergency rooms, and be admitted than others.

Despite the need for proactive care for chronic care management patients, a lot of the providers are still underutilizing this benefit. There are several reasons why providers like FQHCs, RHCs, ACOs, hospitals, individual practitioners, etc. have chosen to leave it on the table.

Complicated Process:

There are several rules physicians and practices have to follow to qualify for CCM reimbursement. CMS has set rules right from enrolling Medicare patients up to the necessary documents that have to be furnished for CCM reimbursement. Other mandatory requirements include providers offering CCM service, having access to patients’ health records, providing 24/7 access to care, providing care plans, and patients being able to reach providers to meet urgent care needs.

Time Consuming and involves additional costs:

Many providers feel offering CCM service is a time-consuming effort, and requires additional staffing. They find it difficult to document each of these and also provide quality care for their patients. Providers feel there is an increased administrative burden to managing and tracking CCM services, and it also involves additional costs.

Patients Consent:

Providers must identify Medicare eligible patients, explain CCM services, and get consent to enroll the patient and start the service. Providers must explain the required information in detail so that the patient can either accept or decline the service. 

Wait and See Approach:

Providers want to first see if the approach is effective before opting for it. Many providers and physicians wait to see if other providers who opt to provide the service have success with reimbursement before committing to participation in the program.

HealthViewX makes the Chronic Care Management process easier with the below features and makes reimbursement simple:

Automated Documentation for CMS Auditing

HealthViewX automates and streamlines the end-to-end CCM process. Integrates with softphones to accurately record the time spent on each call. It easily helps generate reports as per CMS requirements. 

Comprehensive Care Plan

Structured care plans are essential to help organize the coordination of actions for proper patient progression and self-management. The solution helps create condition-specific, personalized, and comprehensive care plans for each patient, including tasks and goals for both the patient and care coordinator track for better care coordination. Simplifies and streamlines workflow to guide tele-nurses in creating care plans. 

HIPAA Compliant

HealthViewX CCM follows HIPAA compliance requirements and guidelines. The solution lets you define the access, has user-specific access conditions, and provide secure access to patient records.

Analytics and Dashboard

Gives detailed actionable insights for better care coordination. Data can be visually represented, and users can gather detailed information by clicking the desired data. The dashboard also displays the follow-up reminders that can be set up by the user against each patient.

Take this simple step to improve health outcomes and reduce costs for patients with multiple chronic care conditions.

Schedule a demo and talk to HealthViewX solution experts today to discuss the CCM solution. Or simply outsource your CCM services. HealthViewX also provides end-to-end CCM services through our network of seasoned RNs and CMAs that enable you to increase your monthly reimbursements without incurring any additional cost of hiring additional staff or investing in technology solutions.