An Ounce of Prevention
One of the biggest care management challenges faced by modern daypractitioners is keeping patients focused on the immediate problem or reason for a visit. It's often easy to default into personal conversations with the patient as you connect as humans, but aimless conversations and off-topic detours can prove lethal to the typical practice schedule and mean certain essential aspects of the visit are overlooked or missed altogether, thus creating potential issues with reimbursement.
The Office of Inspector General (OIG) recently announced it had completed an audit of payments for chronic care management (CCM) services. The results of this audit have short- and long-term implications for providers of CCM services and for the vendors of CCM software that support those providers.
Tucked deep within the 2022 Medicare Physician Fee Schedule proposed rule, presumably where it would be easy to miss, the Centers for Medicare & Medicaid Services (CMS) has penned a love letter to chronic care management.
It's no secret that hypertension is one of the most widespread chronic diseases affecting Americans today. The average American diet and sedate lifestyle have begun to create confounding and devastating effects as Americans age into older adulthood. As more Americans are diagnosed with hypertension, it's important that we fully understand the true cost of this often-silent condition and constructively address ways to create a significant impact on mitigating this gateway chronic disease via solutions such as chronic care management (CCM) and remote patient monitoring (RPM).
Chronic care management (CCM) made its debut in 2015 when it was rolled out by the Centers for Medicare and Medicaid Services (CMS) as a separately paid service under the Medicare fee schedule. The rationale behind its inception was to offer an avenue of compensation for practitioners who provided care to their patients outside of the normal confines of the average office visit. The introduction of CCM coincidentally led to a more efficient means of care teams proactively engaging and managing patients with problematic chronic diseases, in turn improving outcomes and reducing treatment costs.
CMS recently finalized its Medicare coverage changes for 2020 and we’ve found a little something to be excited about. Officially dubbed Principal Care Management (PCM), this new program will allow medical providers to bill Medicare for providing care management services to beneficiaries who have only one high-risk qualifying condition or diagnosis.