Chronic patients care requirements are different when compared to regular patients. In case of chronic patients, the provider should create, and maintain continuous yet flexible care delivery model to accommodate various healthcare requirements. Until the recent past, the provider’s reimbursement plans for Medicare was not flexible enough to hold all the post and pre ER visit care that is necessary for health and well-being of people with chronic diseases.

Chronic Care Management CMS has given providers the needed elasticity and space to work best with their chronic patients. Under the scheme, providers can charge CMS for 20 minutes of non-hospital, non-face-to-face care that they give to patients over a month. This is a great leap in the right direction but given the strict parameters of the program, many providers are concerned that being a part of it will do more harm than good financially. But here are a few steps that can ensure the greater chance of financial success.

Start with the program
Design a standard approach
Employ resources
Review

Start with the program

Yes, this is the less obvious but important step, less obvious because no provider would want to get into a program with outcome unknown. Chronic Care Management has a few unique features such as only one provider shall charge for CCM services. This means by the time a provider makes his mind and assigns resources their patients would have already gone to a different provider.

It is also true that the program and the approach with which it is designed is rather new in the industry today and it will do good for providers to understand and be used to the change.

Design a standard approach

Like all programs CCM would benefit from a standard approach, it will make it easier for providers to alter and adapt it later. A standard approach will also make billing easier & less troublesome. The main idea here is to spot what works best for a practice and if it doesn’t then how it can be changed to arrive at the result that the provider hopes to achieve.

Employ Resources

Provider/ Practice must designate and assign a resource for CCM program. Resources which include human can achieve the objectives better if the program is taken seriously and not like a side assignment without any defined parameters. In most cases, resources are already available and assigned to chronic patients care but adjustments need to be made so that such systems will meet the program parameters.

Review

This step is evident and for the right reasons. The review can help in understanding the causes of malfunction if any. And what is required to make it right and more importantly to know the aim of the exercise – that is improved care quality, is achieved. The introduction of this program CMS has laid the groundwork for healthcare industry’s transformation into a quality based industry in which profitability has linked quality and vice versa. Schedule a demo with us to learn more about Chronic Care Management.