Offering chronic care management (CCM) services for Medicare populations is a great tool to drive clinical outcomes, boost patient engagement, and reach financial goals.
Many choose to outsource their CCM programs; however, not all CCM initiatives succeed. So, what’s the secret to actually finding success with CCM?
The secret is leveraging a CCM solution that:
- Identifies eligible patients and enrolls them for you following Medicare guidelines.
- Is backed by a team of experienced registered nurses instead of medical assistants and licensed practical nurses.
- Provides detailed reports and patient notes to ensure compliant billing.
Identifies and Compliantly Enrolls Eligible Patients
Did you know? Nearly two-thirds of Medicare fee-for-service beneficiaries live with multiple chronic conditions and may be eligible for CCM services.
Considering that:
- One in three Medicare beneficiaries has diabetes
- Three-quarters of adults aged 60 and over have hypertension
- Two of the five most common reasons for inpatient admissions of Americans aged 65 years and over are congestive heart failure and heart rhythm problems
Your organization likely has patients who need help monitoring and improving their health.
However, many organizations aren’t aware of the positive financial impact a robust CCM program could create because they aren’t aware of how many of their Medicare patients are eligible.
Or, if they do know which patients are eligible, they don’t have the time or resources needed to enroll them into a program compliantly—which is extremely time-consuming.
Partnering with a chronic care management company that finds and enrolls eligible patients is a great alternative. We take care of the entire enrollment process for our clients, which entails ensuring all eligible patients provide informed consent and that it’s correctly documented per Medicare guidelines.
Leverages Experienced RNs
Many CCM companies use medical assistants (MAs) and licensed practical nurses (LPNs) to run their programs. Or, some will claim they are “nurse-led,” which typically means multiple MAs work under a single registered nurse (RN).
These CCM models often don’t yield the best results, primarily due to a lack of relevant experience needed for effective chronic care management. While MAs and LPNs have essential roles to play in healthcare, it’s best to have a team wholly composed of RNs running your CCM program.
RNs have the knowledge and skills to provide a much deeper level of care and work with various conditions. They can go beyond preventative care and help patients self-manage their chronic conditions at home, provide coaching to support lifestyle changes, and know when to bring a patient into the office to avoid acute health events.
This in-depth approach to CCM drives clinical outcomes that prompt financial bonuses for those with value-based care (VBC) contracts or quality-based incentives for fee-for-service populations. For instance, financial bonuses tied to closing gaps in care, reducing hospital admissions/readmissions, and/or ER visits.
Plus, RNs can work independently from in-office staff and don’t require the level of oversight or guidance MAs and LPNs may need. And, when you find the right CCM partner, you can feel confident about working with their RNs.
Provides Detailed Reports Needed for Compliant Billing
Your staff is already busy enough; the last thing they want to do is deal with a partner that puts more work onto their plate, especially charting and reporting.
So, if your organization wants to find success with a CCM program, it’s essential to find a partner that delivers quick, detailed, and accurate billing information so you can receive reimbursements—and not denied claims—in a timely manner.
Our team of RNs and software provides audit-grade billing reports, detailed + compliant patient notes and care plans, and Medicare chronic care service logs that integrate directly into your EHR.
See What CCM Can Do For Your Organization
Implementing a CCM program is mutually beneficial for the health of your patients and your organization’s bottom line. With improved clinical outcomes and cost savings on the line, finding the right partner is crucial.
Our chronic care management platform requires no upfront costs or additional work from your in-office staff. Our dedicated team of RNs will identify and compliantly enroll all eligible patients, act as their day-to-day contact to help them improve and manage their chronic conditions, and thoroughly document and report all encounters.
Learn what CCM could do for your organization and schedule a 15-minute demo.
