The advancement in technology has significantly changed the healthcare industry. And now, clinicians can provide better and high-quality services to their patients. One of the significant changes introduced to the healthcare world is the use of Chronic Care Management (CCM) programs. Through these programs, clinicians can easily connect and often speak to their high-risk patients. As such, it offers an opportunity to educate the patient about their chronic conditions and discuss the right treatment plan. But, while many providers are familiar with these programs, many worry that it is expensive, effort demanding, and time-consuming to implement them fully. However, today, we will break down the common myths surrounding CCM programs to help you change your perception of them. Read on to learn more.
First, What Is Chronic Care Management?
Before we talk about the myths around CCM, it is essential we start our discussion from this point. CCM was first introduced in 2015 by CMS (Centers for Medicare and Medicaid Services). It began as a paid service to allow healthcare practitioners to offer services to their patients beyond the usual confines of an office visit. As a result, it became easier to manage and treat patients with chronic diseases, leading to better outcomes.
CCM is simply a program that provides coverage for people with two or more chronic illnesses and allows a continuous relationship with their providers. The clinicians can bill the time they spend treating the patient’s conditions, including remote communication, medication management, designing a comprehensive care plan, etc. Both Medicare and Medicaid reimburse the clinician for the services offered.
Some conditions eligible for CCM include multiple sclerosis, lupus, HIV/AIDs, hypertension, heart disease, diabetes, etc.
Myths about CCM
Now that we understand what CCM means, let’s look at some healthcare myths surrounding this practice.
#1. Working with a CCM Organization Exposes My Patients’ Data
A data breach is one of the worst things you can experience as a medical provider. You need to protect patient information by all means. If it gets out, it affects how you do your business, and you can also be answerable to the law. For this reason, many clinicians may be reluctant to give another organization data on their patients.
It’s normal to wonder whether they will sell that information or steal your patients from you. However, you don’t have to worry. A CCM program is also based on the medical world. Therefore, the organizations also work hard to ensure patient privacy. As such, they will protect their data as much as you would.
#2. A CCM Program Adds More Work to My Already Overworking Staff
While a CCM program sounds like a good idea, you may have concerns about how your staff will handle it. This is especially true if you already have limited resources. You may feel that adding another program can be impossible.
However, rest assured that it is not. In fact, a CCM program will make things easier, provided you have the right resources. It will not affect your day-to-day operations by your nurses, physicians, and other clinical staff. Instead, it will enhance them to work better. What’s more, if you get your program from a CCM vendor, they will handle all the details on your behalf. So, you wouldn’t need to worry about patient eligibility or enrollment claims.
You will need to assign a point of contact with your vendor so that they provide you with monthly updates. You’ll have access to real-time documentation and know all phone encounters your staff had with a patient.
But it is also worth mentioning that your patients do not need to know that your CCM program is outsourced. The organization will work as your office extension. So, your clinic name will pop up on the caller ID whenever they receive a call. The care providers should introduce themselves as members of your hospital’s staff.
#3. Billing for CCM is Challenging
CCM was mainly designed to benefit patients. However, even clinicians can benefit from its revenue-wise. It’s easy to bill for this service since FQHC’s use code G0511 and RHC’s use code 99490. Remember we said providers are reimbursed for offering CCM services by Medicare. The only thing you have to do is to meet the set criteria for the ongoing outreach, development of a care plan, and length of each visit.
Using the G0511, you can get up to $76.94 reimbursement with every encounter per month. So, if one patient gives you $76.94 monthly and you offer your services to 500 patients that month, you will make $38,470. In a year, you will have $461,640 in your account. This added revenue can help you expand your clinic, introduce new programs and hire more staff.
Final Thoughts
Well, those are the common myths surrounding CCM. But, it’s also worth noting that implementing these programs doesn’t take long. With the right company, it shouldn’t go past six weeks. Lastly, we assure you that the patients would be very interested in a CCM program. Monitoring a patient through these programs can significantly improve the outcomes and prevent deaths. So why should patients not be up for it?
