It’s no secret that chronic conditions have become rather common in recent years. As our population continues to age, more and more patients face illnesses that they will need to manage for the remainder of their lives. As providers, it’s important to address these issues, not only when these patients are in the office for a visit, but continuously to see the best health outcomes. This is where Chronic Care Management comes in.
What is Chronic Care Management?
It’s estimated that 117 million adults have at least one chronic condition, with 25% of those individuals suffering from at least two chronic conditions. For these individuals, adequate care is critical to maintaining a good health status. Chronic Care Management (CCM) describes care provided to patients with a minimum of two chronic conditions that takes place outside of a traditional office visit. The patient’s chronic conditions must be expected to last a minimum of one year or until death, and they must have a profound impact on the patient, significantly impacting their ability to function or increasing their risk of death. CCM services are not rendered in-person, but allow the provider to receive reimbursement for 20 minutes or more of care coordination each month.
5 Ways to Streamline CCM
As with any other task in your practice, the more you can streamline chronic care management, the better it will be for both your patients and staff. Luckily, there are ways to ensure this program runs smoothly:
- Begin by identifying the patients who would most benefit from CCM. Start by running a diagnosis report in your EMR software for the conditions which you might like to address through CCM first. Analyze these reports to determine where your efforts will be most beneficial to start and move forward with that group for your initial implementation, knowing you can always expand the program later.
- Make sure your patients understand CCM and what they should expect. To avoid issues, it’s important to make sure your patients thoroughly understand what Chronic Care Management is, what conditions they are under CCM for, what they can expect from you, and what, if any, responsibilities they have with regard to the program. This will ensure that you are all on the same page moving forward and help to make the process run more smoothly.
- Utilize patient engagement technology, like two-way texting, to stay connected with your CCM patients. Leverage technology wherever possible to make CCM more convenient for both you and your patients. Using two-way texting will allow your patients to easily reach your practice when they have a need or concern related to their chronic conditions and will allow your staff to respond efficiently.
- Harness Remote Patient Monitoring (RPM) to help with monitoring your chronically ill patients. RPM allows patients’ conditions to be closely followed and analyzed with alerts sent to providers when evidence of an issue is indicated. This is a great way to seamlessly keep track of your chronically ill patients without putting a strain on your clinical staff.
- Choose an EMR with a module that makes tracking and billing for CCM services a breeze. In order to qualify for reimbursement for CCM, you have to provide a minimum of 20 minutes of virtual care to the chronically ill patient you are billing for within a month. It’s important to closely track the care you provide to each patient so that you are paid for the services you provide. Choosing an EMR with a module specifically for this task makes this documentation simple and convenient.
Chronic Care Management is an important piece of providing outstanding patient care and seeing positive health outcomes. While the idea of adding to an already heavy workload can seem daunting, by streamlining your CCM program, you can reduce the burden on your staff while also improving patient care.
At Henry Schein SolutionsHub, we understand how important that balance is, and that’s why we work tirelessly to find the best solutions for your practice. For Remote Patient Monitoring, we’re proud to offer Rimidi and Carium as options to allow for continuous monitoring of your patients without adding to your workload. We also offer Henry Schein MicroMD EMR with its integrated CCM module to make tracking and billing for chronic care management simple.