In 2015, Medicare launched Chronic Care Management (CCM), a program incentivizing practices to follow up with chronic condition patients outside the office between visits. Other programs followed to improve health, like Behavioral Health Integration (BHI), which focuses on follow-up between visits for patients with mental conditions. These programs provide a significant financial incentives to providers, up to ~$42-$80 per  patient per month, or up to $200K+ per provider annually. 

However, despite these programs’ health improvements and systemic cost savings, many doctors and their staff lack the infrastructure and extra staff to implement them.

CircleLink Health conducted a survey of 51 primary care providers and 9 cardiologists to determine their general level of CCM awareness and preparedness. The results suggest that while physicians believe their practices could benefit from CCM/BHI, they struggle to implement these programs effectively. In fact, despite 77% of physicians polled being aware of Chronic Care Management’s launch in 2015, only 12% reported they are billing for CCM consistently.

The Challenges of Treating Patients with Chronic Conditions:

Patients with chronic illnesses can be time-consuming for practices. For instance, follow-up calls that can ensure these patients take their medication and understand their doctors’ instructions take hours per week. Specifically, our poll showed most doctors’ staff spending between 8-20 hours per week on such follow-ups. (62% reported their staff spent 8+ hours each week on such calls.)

Medicare Chronic Condition Chart

Even with the above time being spent on follow-ups, only 7% of physicians polled reported their staff always having more than enough time to call their chronic condition patients in between appointments. 

Which makes sense: Office staff are crucial to the day-to-day operations of practices. Spending hours on the phone with these chronic conditions patients can disrupt their workflow. Having new resources funded by CCM or other preventative programs can free up staff to focus on patients who need attention in-office, among other priorities.

The Challenges of Implementing CCM Programs:

Although preventative care programs like CCM seem to be a perfect solution to these challenges, our survey found that physicians struggle with finding the needed staff time, resources and infrastructure.

Per the below chart, the three most cited barriers are (among the 65% of respondents who hadn’t launched):

  • Lack of staff time required for new revenue programs
  • Difficulty in understanding complex program requirements
  • Unfamiliarity with these programs’ reimbursements

Barriers to implementing Medicare preventative health programs chart

In addition, finding time to research how to implement a CCM program can be difficult for physicians and staff who fill their entire workdays with clinical matters. The complex regulatory environment and resulting operational needs surrounding these programs/reimbursements makes this work time consuming. 

CircleLink Health Can Help Your Practice Implement a CCM/BHI Program:

Luckily, CircleLink Health provides the technology, telephone RNs and guidance physicians need to implement successful preventive care programs with zero additional staff or upfront costs. From full-service CCM/BHI solutions to customized/targeted offerings based on practices’ needs, CircleLink can help. Interested in learning more? Send an email to raph@circlelinkhealth.com.