A new program began by CMS in 2015 is demonstrating good results.  Chronic Care Management is showing a positive ROI for physicians and for CMS.  In a report posted last week, CMS demonstrated that spending per beneficiary participating in a CCM program dropped by over 15% from the beginning of 2015 to the end of 2016.  The cost per beneficiary for $1,395 during the first six months, and dropped to $1,192 during the last six months.  CMS estimates the program produced a net savings of $36 million during the second year of implementation.

Chronic care management encompasses the oversight and education activities conducted by health care professionals to help patients with chronic diseases and health conditions such as diabetes, high blood pressure, lupus, multiple sclerosis and sleep apnea learn to understand their condition and live successfully with it. This term is equivalent to disease management for chronic conditions. The work involves motivating patients to persist in necessary therapies and interventions and helping them to achieve an ongoing, reasonable quality of life.

Quality Improvements Are Essential To Program

But positive ROI alone will not satisfy the healthcare systems challenges.  CCM programs are patient-centric, and put their needs first, and lead to a higher amount of patient engagement.  Research shows many benefits resulting from this, includeing:

  • Reduced hospital admissions (and readmissions)
  • Reduction in wasteful spending and redundant testing
  • Improved self-management of care
  • Higher engagement of family members and caregivers.

Anecdotal evidence aside, there is clear support of the program from participants.  In a 2016 survey of more than 100 chronic care patients treated by providers using CPT code 99490, the results showed that almost 90 percent are satisfied or very satisfied with the clinical engagement services.

Implementing a Chronic Care Management Program

Implementing a CCM program is easier today than ever.  ISeeYouCare’s platform can be used to manage your entire program. You can see how Chronic Care Management is showing a positive ROI for other systems.  Whether you use your own staff, or contract our services to manage the program for you, we can satisfy all of the requirements for CMS reporting.  Contact us to start a pilot today.