Implementing Successful Chronic Care Management Programs in 2021: Best Practices

Chronic Care Management (CCM) has been a wildly successful venture for many healthcare providers in recent years. It is helping patients achieve incredible outcomes through the alignment of their providers, care coordination, and complex and comprehensive health plans they can keep track of. Patients who were likely to have a poor quality of life due to their chronic conditions are now seeing remarkable results.

Providers are also reaping significant benefits from the implementation of CCM programs. Chronic Care Management has the potential to help providers boost their bottom line and improve the quality of care they can provide to patients. The key to a successful Chronic Care Management program is to get off on the right foot.

Best Chronic Care Management Practices

Understand the Policy

Too many providers have jumped headfirst into implementing a CCM program they do not fully understand, leading to failure. Really understanding aspects of CCM like which patients qualify, visit requirements, and the role of your team are key to success in rolling out this program in your practice. Understanding the policy behind Chronic Care Management creates the foundation for success.

Understand Who Can Bill

The billing component of Chronic Care Management can seem quite overwhelming. It is important to understand exactly who in your practice is eligible to bill for CCM visits. Eligible professionals that can bill for CCM include physician assistants, clinical nurse specialists, nurse practitioners, certified nurse midwives, and eligible physicians.

Educate Your Patients

For patients to reap the benefits of a quality Chronic Care Management program, they need to understand it and how it can help them. Invest time and resources into educating your eligible patients about what CCM can offer them. Share educational materials with them during visits, over the phone, and around your building. The more they know about it this care option, the more likely they are to sign up.

Get Patient Consent

Once a patient understands how Chronic Care Management can benefit them, your practice needs to get their consent. Written consent from a patient will allow you to enroll them in your practice’s CCM program and start caring for them in this way.

Establish Comprehensive Care Plans

To adhere to CMS CCM requirements, providers need to have a comprehensive digital care plan for every patient enrolled in the program. A care plan should include a comprehensive assessment, a list of their current problems/conditions, a treatment plan and goals, resources associated with their care, and medication management.

Track Everything

It is important that your practice tracks everything that relates to a CCM patient’s care. This should include the time you spend with them in the office, over the phone, and any other time dedicated to their care. Your documentation should detail the time you spent on them as well as what was included in the interaction.

Outsource CCM Services

The most important thing your practice can do to truly optimize your chronic care management program is to outsource these services to a highly qualified vendor who can help your team optimize return, improve patient care, and adhere to all CCM compliance. To learn more about a qualified CCM vendor, click here.