Characteristics of a Successful Chronic Care Management Program
An estimated 35 million Medicare patients are eligible to participate in the new Chronic Care Management (CCM) program. To date, only about 150,000 have enrolled. Why?
Justified skepticism of any “new” Medicare program by physicians, disruptions to practices, difficulties implementing and running a successful program, record-keeping requirements, compliance, expense of time, money, and staff resources, and low to zero return on investment are some of the many reasons cited by practices when asked about their concerns with CCM.
Most practices are in one of two camps in regards to CCM. One, they are interested in implementing a program but are waiting to hear success stories from other colleagues, or two, they have implemented a program and are finding it difficult to run and are probably only billing around 20% of the patients they have enrolled. Hardly worth it!
What makes this issue more frustrating or confusing to many is the constant chatter from vendors in the CCM marketplace stating how easy this is for physicians to implement and bring in significant new revenue to their practice (While not mentioning how this may benefit the patient or provide better patient outcomes).
I will agree and state that much of the claims surrounding this program are simply just “sales pitches”. However, having said that, there are many practices running very successful programs and their patients are benefitting greatly. My goal in writing this article is to hopefully cut through the confusion out there and provide some valuable information on what a successful CCM program looks like and give you something to compare to if you are thinking of implementing a CCM program or already have and are not very satisfied with the results.
Characteristics of a Successful CCM Program –
• PATIENTS ARE BENEFITTING AND BETTER PATIENT OUTCOMES ARE CONFIRMED BY DATA
• Little to zero time is required of staff and physicians to run program.
• No disruptions to daily routines of practices.
• Zero investment to implement program.
• Zero compliance concerns. Written guarantees provided that all reporting will pass any CMS audit and ALL required reporting is automatically done for you.
• Program provides a healthy revenue stream to practice. $175,000 or more in NET annual revenue per 1000 Medicare patients should be realized.
• Data confirms that costs within system are going down.
• Vendor offers options that provide additional patient benefits and practice revenue, such as, leveraging the Annual Wellness Visit to achieve greater results.
As stated before, it is possible to implement a successful CCM program and running it can be done without disruptions and difficulties. When designed properly the goals of Medicare can be met, the rewards for the practice can be great, and most importantly, chronic patients can enjoy better health!
Brian Bibb is the representative to GAFP for CircleLink Health and was the Draw Down Presenting Sponsor at this year’s Scientific Assembly in Atlanta. For questions or more information you can contact Brian by phone at (904)-477-8456 or by email at bbibb@circlelinkhealth.com