Almost one-third of Americans have multiple chronic health conditions, and among people over the age of 65, prevalence rises to 80%. Hypertension, diabetes, cancer, Alzheimer’s, osteoporosis, and many other chronic conditions affect a person’s quality of life and daily living experiences, and they may also increase the risk of associated health issues. Patients with chronic health conditions often require more appointments and may end up in the hospital more frequently if they fail to follow physician recommendations or take medicine as prescribed.

Chronic Care Management (CCM) can improve these outcomes by following up with patients to answer questions, ensuring that they are adhering to the recommended care plan, and educating them about how to manage their conditions. CCM may also assist in early identification of changes in patient health status and increasing patient access to the resources of your practice.

Under Medicare’s CCM program, healthcare practices receive reimbursement for CCM services under CPT Code 99490 when they meet program stipulations that include securing patient consent and providing at least 20 minutes of non-face-to-face interactions per month.

How to Design A Chronic Care Management Program That Benefits Patients

Potential benefits of chronic care management include fewer hospitalizations, fewer appointments, and better overall health maintenance. The key to achieving these benefits is to carefully implement CCM best practices that help patients feel valued and well-cared for.

Emphasizing the following three best practices during each interaction will help you build trust, encourage participation, and promote compliance.

  1. Empathy –The goal of CCM is to improve outcomes for patients by encouraging them to follow their recommended care plans. One of the most important ways to do that is to demonstrate care and understanding for the patient’s needs as you communicate with them. Although documented time is a requirement for Medicare reimbursement, it is essential that patients feel that the focus is on them and not on the amount of time being spent on the interaction. Showing empathy lets patients know that you care about what they are experiencing, and it has the potential to improve both patient satisfaction and adherence to treatment plans.
  2. Encouragement – Changing patient behavior is one of the most difficult aspects of chronic care management. Many patients don’t understand the severity of their situation, and therefore see little reason to follow through on the treatment plan. Open communication combined with timely follow-up can provide the gentle push needed for patients to continue with medications, lifestyle changes, and rehabilitative therapies. During a follow-up phone call, listening to concerns and questions before offering advice helps build the kind of trust that persuades the patient to act on physician recommendations.
  3. Education – Ongoing education helps patients become more knowledgeable about the specifics of their conditions and gives them the resources they need to manage their health effectively. The more people understand the health conditions they have, the more they will be able to reduce associated risks and improve their day-to-day functioning. Timely education can also help patients address potential complications before they become major issues.

Why Chronic Care Management Is a Good Investment

The most common reasons physicians don’t seek Medicare reimbursement for CCM are that the coding seems complicated and that applying for reimbursement requires extensive documentation and paperwork. Despite these factors, however, CCM still benefits your practice by reimbursing you for activities that improve outcomes for your patients.

HealthXL®’s Chronic Care Management solution solves the problem of administrative burden by managing each step of the process for you so you can focus on your patients. From time tracking to phone interactions to billing submissions, we make CCM easy. Contact us today to learn how we can help you get paid for what you already do best: caring for your patients.