How to Implement an In-house CCM Program

It is a serious undertaking to run an In-house Chronic Care Management (CCM) program as it needs significant resources and staffing. According to ThoroughCare, Medicaid and medicare services estimate that about one out of four people have two or more chronic issues, thereby validating the need for CCM. Although a clinic might consider outsourcing the CCM program, there are still concerns about the chosen partner’s trustworthiness.

Nevertheless, pooling resources internally and outsourcing are good decisions as long as the chosen approach gives patients high care levels. Successful implementation of Chronic care management takes many coordinated steps; each needs time, people, and infrastructure as the starting point. In-house CCM services have many benefits and take many coordinated steps. These include mastering the training and recruitment process, separating care and enrollment teams, allowing nurses to work together with the same patients and providers, and educating the staff and the providers.

a. Mastering the training and recruitment process

To achieve an accurate scale of the CCM in-house program, you need to enroll at least half of the clinic’s eligible patient population. To achieve enrollment numbers, there is a need for intense training, a robust recruiting infrastructure, and a clear definition of the preferred talent in hiring recruiters. Moreover, it is advisable to have knowledgeable recruiters that can select fit candidates with the required skills and expertise. Remote nurses should also have experience and be self-empowered, with solid job ethics and capabilities to work from home.

b. Separate care and enrollment teams

This is the cornerstone that ensures success in the in-house CCM program. Nurses are meant to give care to patients and not act like salespeople. If you task nurses with enrollment, it will be a waste of their training and talent to onboard patients. Enrollment should take a different skillset from that of nurses. To focus on the patient, it is advisable to allow nurses to focus on that.

c. Allow nurses to work with some patients and providers.

Good relations are vital for in-house CCM, as they stimulate a patient’s engagement. Nurses should therefore engage with their patients and similar doctors. This will make it easier to implement the program.

d. Educating staff and providers

Although it can be a complicated stage, it’s vital for effective CCM implementation. The team providing care, which includes clinical staff, has to be ready to advocate the programs supplied by CCM management. The staff needs to fully understand and believe in the program to be able to promote it. Of course, informing the care providers about the program implementation is the only way to result in success.

In educating your staff and care provider, you can leave training sources for those care staff to pass the information to the patients. By doing so, the patients will be able to develop value and wellness in improving health upon implementing an effective CCM program.

How to implement in-house chronic care management services in your clinic?

You can implement an in-house CRM program, but it often requires significant resource loads and an excellent plan to help you get started. Here is a list of what you need:

1. Additional personnel

Adequate staffing is always a significant challenge in implementing any program, even more so when implementing an In-house CCM program. It is better to add additional specialized staff to manage the CCM clinics than have the nurses involved in this process. The new staff needs proper training on top of the training they already have. Therefore, the CCM program should be halted until all additional staff gets enough quality management and compliance training as you bring in new staff. Often nurses can overlook or neglect daily details if they are overloaded with too many in-house CCM tasks. Nurses’ main focus should rather be on providing direct care to patients and focusing on cases. Therefore, running checkups and calls should have a different staff portion to interface with nurses appropriately.

2. CMS implementation and compliance

After staffing, the next critical thing is implementing the CMS compliance system and training the staff. This includes how the clinic will document and record patient interactions to promote compliance. Therefore, it is necessary to weigh the advantages and disadvantages of using an internal or external management system. The external systems include additional training for existing staff, new hires, and new software onboarding. On the other hand, internal management systems imply that a project lead should be contracted or hired to create compliance systems.

3. Enrollment pathways and tracking systems

A systematic approach emphasizing real-time response and preventive needs is vital for effective CCM programs. So, to set up an effective customer relations management (CRM) program, you need to have proper enrollment pathways and tracking systems. In CCM, there is a need to ask preliminary questions to reveal patient needs that aid in identifying vulnerabilities that require immediate or scheduled care. Managing patients with different illnesses takes different approaches since every condition needs a specific conversation to understand the patient’s needs. In-house CCM is an intensive program that can consume a lot of time. So, it requires balance while committing time to each patient while being consistent.

Conclusion

While implementing the in-house CCM program is one way to diversify healthcare on chronic issues, clinics need to choose an approach suitable to provide patients with the greatest care. What clinics should ensure in implementing CCM is the requirements such as adequate personnel, tracking systems, and enrollment resources.

Related article: Benefits of a CCM Program for Patients and Clinics