Tag Archives: chronic

Rising popularity of CCM – Common Chronic Diseases In The USA

Chronic illness rates are increasing year by year and are taking a toll on the nation’s population. Serious chronic diseases like stroke, diabetes, cancer, heart disease, etc. are one of the leading cause of increased death rate in the country. More than 75% of healthcare spending is on people with chronic conditions. Beyond any statistics, medication non-adherence is a poor clinical outcome and overcoming this is another great challenge. Thus, doing more to take care of the population health is crucial.

Even today, we witness patients suffering from poor access to healthcare and it is continuing to increase. So improving quality of life for people with chronic disease is vital and is an epidemic in the USA. Simultaneously, the burden of multiple chronic illnesses is also increasing rapidly. In one of the recent release, it is noted that two-thirds of Medicare patients have two or more chronic conditions; another one-third have four or more.  The growing impact of this condition is placing a huge economic demand on the nation. Utmost care has to be taken to address this growing condition, and addressing it will not only reduce cost but also increase the quality of life.  Taking steps towards better health and using care more effectively is a need today.

Chronic Care Management is a boon to both the providers and the patients. The Center for Medicare and Medicaid Services (CMS) has taken a lot of new initiatives to raise awareness of the benefits of Chronic Care Management. This initiative offers family physicians and other healthcare specialists the support they need to implement Chronic Care Management in their practice. It is all about providing care to patients with chronic illness through a framework for embracing healthy life, improving patient health and increasing revenue.

The prime goal of CCM is to improve care quality through remote monitoring and managing patient health conditions better by creating care individual care plans for each of the patients for achieving better health outcomes.

Chronic Care Management promises the below

  • Continuity of care by the provider.
  • Individual care plan for patients.
  • 24/7 access to healthcare.
  • Assessment of patient health records, patient-generated health data.
  • Access patient health information at regular intervals.
  • A secure electronic platform to share patient information and care plans
  • Managing care transitions

Apart from this Chronic Care Management includes non-face-to-face care management and care coordination. The transition from fee-for-service to value-based payment has a huge impact in the healthcare industry. And the CCM billing model makes it possible by getting paid for the time and effort the care team invests in their patients. It is evident that this is benefitting both the patient and the provider. CCM has gained in traction through the value the physicians bring in by delivering continuous and connected healthcare. For the past many years, physicians have helped patients over the phone but never got paid for it. But now with the introduction of Chronic Care Management (CCM) by Center for Medicare and Medicaid Services (CMS) this has been resolved. Patients can elect one physician to take care of their CCM program. The elected CCM physician or provider must establish, implement, revise, or monitor and manage an electronic care plan that addresses the physical, mental, psychosocial, functional, and environmental needs of the patient as well as maintain an inventory of resources and supports that the patient needs. Thus, the practice must use a certified EHR to bill CCM codes. The CPT CPT codes 99490 and 99487, and the add-on CPT code 99489 is a new source of revenue for the physicians’ and other care providers.

And it is no surprise that CCM is gaining popularity among all the care providers, physicians, and patients. Schedule a demo with us to know more about HealthViewX – Chronic Care Management Solution

Era of A Personalized Care

Humans differ in terms of DNA & Genome Composition. This factor may not necessarily surface as a disorder or a disability but will create variations in the manner each person responds to drugs and treatment for a disease or a condition. In any given population, there is a chance that a group exists who do not respond to any given medication in the desired manner.

Personalized medicine is the practice of designing and conducting medicine tailored to suit an individual patient’s needs with procedures, drugs and treatment approaches. Personalized medicine has been the war cry for many healthcare reformists for decades, but now there is more likelihood of the general healthcare practice widely adopting the idea because of the following reasons.

Change in regulation
Change in attitude
Healthcare technology
The current model is ineffective

Change in regulations:

The US healthcare regulations are changing giving way to implement the new methodology of care delivery and management. The provider reimbursement is being made flexible allowing healthcare professionals the space to adopt their practice for the benefit of each individual. Change in regulations also will lead way to alterations in the structure of organizations; the organizations will be revamped to be more collaborative and serve a population that is demanding quality and services that match any other industry’s methodology.

Change in attitude:

Providers of today have many tools at their disposal and partially due to this reason providers are more willing to embrace change and improve the lives of those whom they serve. The complexity that the modern medicine requires and the practice of handling a large amount of data is almost impossible to manage and generate result without healthcare IT.

Healthcare Technology:

Healthcare Technology is improving and evolving tremendously, allowing both providers and the patients not only to keep track but actively engage in Care Management. The data that is collected by connected devices and the quality of information that is gathered by hospital systems allows for an in-depth analysis of healthcare conditions and concerns.
For those not residing in cities, Healthcare IT means fast care with the focus on those suffering from chronic conditions. In personalized medicine, Healthcare IT can be used to gather personal information and monitor the effects of treatment and medication, and also play as a channel to direct personalized care.

The current model is inefficient:

The current model is inefficient and rigid to incorporate the necessary changes that need to be made to accommodate all the variations required in care delivery. The results are varying and the outcome cannot be accurately predicted. The healthcare sector now works under the assumption that reaction to a medication or procedure is the same for every individual. This is a risky assumption and one which is costing the public their health and money.

Personalized medicine is the future of healthcare, it is the next big idea that is going to shape healthcare delivery for the times to come incorporating technology. We at HealthViewX understand this, and we are determined to create healthcare delivery tools that collect useful patient information to help providers make choose the right path always.

Profiting From Chronic Care Management

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.