Senior citizens with one or more chronic conditions have a hard time managing their health. CMS was spending a lot of money on patient’s insurance who were suffering from chronic conditions. In order to cut down the expenses on hospital admissions, the CMS introduced the Chronic Care Management program. Patients usually visit their physicians for chronic care once or twice a year. With Chronic Care Management program, patient’s health improves due to increased attention and care. They can also spend less time on health issues and more on what they like to do.

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1
Physicians Complete Guide to Chronic Care
Management
www.healthviewx.com

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Senior citizens with one or more chronic conditions have a hard time managing their health. CMS
was spending a lot of money on patient’s insurance who were suffering from chronic conditions. In
order to cut down the expenses on hospital admissions, the CMS introduced the Chronic Care
Management program. Patients usually visit their physicians for chronic care once or twice a year.
With Chronic Care Management program, patient’s health improves due to increased attention and
care. They can also spend less time on health issues and more on what they like to do.
Why Chronic Care Management?

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Medicare defines Chronic Care Management program as non-face-to-face service provided to its
beneficiaries with multiple (two or more) significant chronic conditions. In addition to office visits
and other face-to-face encounters (billed separately), these services include
● Communication with the patient
● Health professionals being available both electronically and by phone for care coordination,
medication management, and being accessible to patients.
What is Chronic Care Management?

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Time Consuming Process
Chronic Care Management program requires a lot of time and effort from the physician.
Unfortunately, providers must meet a number of requirements to qualify for a CCM
Medicare reimbursement. The list goes on at considerable length defining the care a
practice must give.
The fact sheet offered by the CMS goes up to eleven pages with multiple requirements
to bill for CPT code 99490. This can become quite cumbersome for any practice,
considering that the Medicare reimbursements are only $42.60/patient/month.

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Time Consuming Process
● Twenty minutes of non-face-to-face conversation per month with the patient
● Use of a certified EHR
● Create a patient care plan based on the assessments and available resources
● Provide the patient with a copy of the monthly updated care plan and document the
same in the EHR
● Ensure that the care plan is available electronically to anyone within the practice
providing CCM services
● Share the care plan electronically outside the practice as appropriate
● Ensure 24/7 access to care management services
● Ensure continuity of care with a designated practitioner or member of the care
team who will take care of successive routine appointments

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Steps to Improve Chronic Care Management

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Build a Strong Team
If a practice chooses to offer CCM services, it will be an investment. The demands include
● Additional staffing with additional salaries,
● Benefits and increased workload for management.
● Additional office space depending on your current facility
It is important for the practice to set up a plan of action to calculate the required additional
staff members required and the exact cost of this service. The practice must,
● Assess how many patients in the practice will be eligible to receive CCM services.
● Identify how many people are needed to give quality CCM services to their patients and
also additional salaries and benefits, added office space, etc.
It is important to analyze the merits and demerits from a financial perspective. Even if a
practice is not profiting from CCM in the first stages, it is always possible to derive profit
later.

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Outsourcing Chronic Care Management Services
Many private practices and hospitals who want to offer CCM services but cannot the
implementation process can opt for outsourcing their CCM. There are vendors who
provide this service and understand the new requirements better for reimbursement
eligibility. In essence, they become an extension of the practice and require minimal
financial investment from the provider. By this, the practice can manage the risk factors,
patient experience, and profit better. A study on outsourcing chronic care management
for diabetes patients found that those who participated in the outsourced care,
● Rated the experience more positively
● Demonstrated better clinical outcomes than those who received clinic-based care

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Chronic Care Management software can reduce the time and the manual effort spent in giving the
CCM services
Using CCM Software

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Features of HealthViewX CCM Software

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1 Automated call log feature
After a call, care plan creation or any action related to CCM health services,
the system automatically adds call logs. It reduces the physician’s manual
effort is logging the call logs.

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Preventive Care Plans
2
HealthViewX solution supports care plans for the Chronic Care Management
service for a patient. The physician can create a care plan depending on the
patient’s health report. It helps in monitoring the patient’s vitals.

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Chronic Care Management
Analytics3
Dashboards with intuitive charts and tables give complete analytics of the
Chronic Care Management services. It provides a clear picture of the revenue
perspective

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4 Consolidated Reports
The physician can generate a consolidated report of the Chronic Care
Management services given for a particular period. This makes it easy for
the billing practitioner for getting the Medicare reimbursements.

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HIPAA Compliance
5
HealthViewX Chronic Care Management is HIPAA compliant. It facilitates
secure data exchange. The solution manages all patient-related documents
securely.

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HealthViewX Care Management and Chronic Care
Management solutions have features that suit
healthcare organizations best.
To know more about our solutions, schedule a
demo at www.healthviewx.com
Schedule a Demo with HealthViewX

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