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Crucial Aspects of Medicare Chronic Care Management

Various research studies have concluded that chronic care management is immensely effective in reducing the costs for the treatment of patients suffering from chronic diseases. And not only that, chronic care management also plays an important role in improving the health condition of patients by ensuring better health monitoring and timely care. The typical non-face-to-face care management services like medication reconciliation, coordination among healthcare providers, arrangements for social services, remote patient monitoring and remote patient assistance are done at the background and the payment for these services is included in the payment for face-to-face medical evaluation and management services given by healthcare providers.

Obviously, these payments for different background services crucial to the evaluation and treatment management do not include the cost of appropriate medical staffs and investment for technology in the chronic care management process. This gives rise to a situation where healthcare providers do not become able to provide these elements in their chronic care management plan in an adequate manner. This results in lack of caregivers and monitoring in various phases of treatment. From the perspective of overall healthcare standard and qualitative approach such a situation contributes to the increasing rate of health complications in chronic patients which further translates into more suffering and increased healthcare cost. New Medicare chronic care management embraced by most reputed healthcare providers is a solution to this.

From the 1st January this year CMS unrolled its Medicare CCM plan facilitating reimbursement for healthcare providers taking care of patients suffering from multiple chronic health problems. This obviously made a significant leap in the care of the chronic patients as so called cost constraints will not play a deterrent role for the process of remitting care and treatment to patients. Moreover, with inclusion of terms such as “non-face-to-face” and “outside-of-the-office” will encourage healthcare providers to introduce modern remote monitoring and communication technologies like monitoring apps and tools, video conferencing and other high tech interfaces.

A recent survey conducted by Kryptiq stated that 76 percent of respondent healthcare providers reacted positively to this new chronic care management reality and said that they would improve the structure and organize better to meet the present requirements for chronic care management in the span of next six months or so. A whopping 92% of respondents among healthcare providers expressed that they would like to meet the current Medicare CCM requirements within a year.

The new requirements for CCM services include an array of aspects including non-face-to-face care management and coordination of chronic care with other healthcare providers. It has been regulated that caregiver teams at least should spend 20 minutes of time per patient in a month and they have to document their healthcare service when visiting the patients. The following are the specific requirements.

• Healthcare team or personnel maintaining continuity of care.

• Providing and equipping patients more in communicating with the caregivers.

• Round the clock access to chronic care management services

• Comprehensive chronic care management including proper assessment of diver requirements of patients like medical, functional, and psychosocial needs and focus on preventive care, medication reconciliation, and self-management of medication by the patients.

• Electronically equipped care plan information offering unrestricted accessibility to all parties.

• Continuity of care beyond hospitals and healthcare facilities.

Oculus Health has developed a medication tracker app for personal health management which enables care team and doctors to provide the patients with the right treatment at the right time to improve patient engagement and meet Medicare’s chronic care management needs.

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