Chronic care management (CCM) is a valuable service to provide to patients that generates strong revenue for practices, and, as we recently discussed, is an "integral component" of the Centers for Medicare & Medicaid Services' (CMS) long-term patient care and coverage strategy. There may be no better time to add or grow a chronic care management program, especially with a reimbursement increase likely on the horizon.
To maximize the benefits of a CCM program for your patients and practice, you'll need the right CCM software to support your efforts. With the number of chronic care management companies offering software on the rise, choosing the right platform may seem easier said than done. That's why, in this blog, we'll identify some of key qualities you will want to look for in the CCM technology you invest in.
Before we dive into those qualities, let's briefly review some background information on CCM.
CMS defines chronic care management as "care coordination services done outside of the regular office visit for patients with multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbations/decompensation, or functional decline. These services are typically non-face-to-face and allows eligible practitioners to bill for at least 20 minutes or more of care coordination services per month." (Note: Learn definitions of other common CCM terms in this glossary.)
With more than 60% of Americans suffering from at least one chronic disease, and 40% battling two or more chronic diseases, there seems to be no shortage of patients who might qualify for chronic care management services. As further incentive, Medicare and other large payers have embraced chronic care management, seemingly cementing it into today's healthcare landscape.
To learn more background information on CCM, including what is considered a chronic care management-eligible chronic condition, coding and billing rules for the two types of CCM, as well as how adding remote patient monitoring (RPM) and behavioral health integration (BHI) can help further grow your chronic care management program, read this blog.
By now, your practice is most likely using an electronic health record (EHR) system. Finding that system was probably a stressful and challenging process, and one that you may have needed to perform a few times if your first choice didn't work out. It's a process we suspect you'd like to avoid repeating again any time soon. To make the selection and implementation of chronic care management software easier, it's important to find CCM technology that compliments your established workflows and plays nicely with your chosen EHR system. To help, here are five other important qualities to consider when researching chronic care management companies and working to choose the right CCM software for your practice.
With big companies across all industries falling victim to cybercriminals, it's more important than ever to best ensure your patient's health information and clinical data is safe and secure. A recent article published by Leftronic pointed out that 89% of healthcare providers experienced some sort of data breach within the last two years, and that each stolen healthcare record costs healthcare institutions an average of $429. If a breach caused an entire patient panel to be exposed, that could not only bankrupt a smaller practice, but harm a reputation beyond repair.
As you compare chronic care management software options, be sure to review the security features and ask questions of potential vendors about the technologies and training tactics they use to help ensure data security and protecting the patient health information that will be managed within the CCM software.
Anyone who plays the insurance game, regardless of whether it’s with Medicare or other commercial payers, knows that their rules can change — often with little notice — and it can be difficult to keep up with the revisions that directly affect your practice and its delivery of services.
Your CCM technology vendor should have processes in place to identify when rule changes are scheduled to occur and take action to ensure their CCM platform is ready when those changes take place. A good chronic care management software program should also make any required data reporting easy, granting you access to well-organized information in easy-to-understand reports.
A key question to ask chronic care management companies: How well does your CCM software get along with other software solutions? Charting the same patient's information multiple times is not only redundant but also inconvenient. Effective CCM technology should have a simple-to-use and understand CCM dashboard to help your healthcare team quickly and easily identify the current care status for each patient. This will better allow you and your team to serve your growing patient base more effectively and efficiently. Your practice can save time and money by allocating time to finding a CCM technology that will integrate with your existing EHR while not disrupting your current workflows.
Chronic care management software should not only play well with your existing EHR system, but it should also help automate other processes. These include but are not limited to the following:
More than 61 million Americans were enrolled in Medicare or Medicare Advantage plans in 2020, according to KFF data — a figure expected to continuing growing substantially. Also projected to grow substantially: the number of people with chronic conditions. Thus, the number of Medicare patients that would benefit from CCM services will be increasing as well.
How can your practice catch all the patients within your panel when they become eligible for chronic care management? This is where the right CCM technology can shine. A good chronic care management software program should work well with your existing EHR system to ensure patients are effectively identified when they meet the qualifying requirements for CCM.
While still a fairly young aspect of healthcare, chronic care management is proving to be good for patients and good for healthcare providers. With the expectation of high-quality, wraparound services within the primary care model, CCM allows you to provide patients with close disease monitoring coupled with the more aggressive and frequent follow-up care needed to prevent acute exacerbations, emergency room visits, and hospital admissions. Even better, chronic care management reimbursement currently comes in at around $40 for every 20 minutes of time spent on a patient per month and averages around $120 per month per CCM patient — figures that may increase in 2022. This makes chronic care management a great source of revenue when it's completed effective and efficiently.
Choosing the best chronic care management company to work with will help make the delivery CCM even easier and more lucrative. Furthermore, a good chronic care management software program can also support other care management services, such as BHI and RPM.
Behavioral health integration is nearly identical to chronic care management, instead focusing on patients' mental and behavioral health rather than other more tangible chronic health diseases. Remote patient monitoring provides patients with wraparound support and frequent follow-up care from afar, often preventing the need for more frequent in-office care and helping reduce readmissions and emergency room visits. RPM uses connected, digital technology, to monitor the patient's health status from wherever they are located and then sends real-time updates to their healthcare team for quick evaluation and intervention if needed.
Chronic care management and other care management services are here to stay. CCM is proving to be an effective solution for keeping patients healthier for longer while ensuring consistent and strong revenue for practices. Both of these significant benefits will be magnified by making the right choice of CMM software after completing your research into the leading chromic care management companies.
With no shortage of options, it's important to focus on finding a technology partner that integrates well into your existing operations while always treating security and compliance as high priorities. With the right CCM software in place, you will find it even easier for your healthcare team to provide these incredibly valuable services to your patients.