CMS Is Boosting Chronic Care Management Reimbursement In 2022: The Secret Reasons Behind

Chronic Care Management (CCM) has manifested to be an important part of the care continuum, especially during and after the major impact of the COVID-19 pandemic, and has proven to have value for patients, providers, and payers.

In the inference of the scheduled reimbursements increase for 2022, CCM has proven its worth.

What Is Chronic Care Management?

Chronic care management encompasses the oversight and education activities conducted by health care professionals to help patients with chronic diseases and health conditions such as diabetes, high blood pressure, systemic lupus erythematosus, multiple sclerosis, and sleep apnea learn to understand their condition and live successfully with it. 

This term is equivalent to disease management for chronic conditions. The work involves, 

• Motivating patients to persist in necessary therapies and interventions, and
• Helping them to achieve an ongoing, reasonable quality of life.

The Centers For Medicare & Medicaid Services (CMS) Role In The Boosting

The CMS released its final official 2022 Physician Fee Schedule, which became effective from January 1, 2022. The final rule includes increased reimbursements for chronic care management (CCM).

Chronic care management has begun to be recognized by the CMS in 2015 when the CCM reimbursements were first included in its physician fee schedule. Then onwards CCM was considered by CMS to be a “vital piece” in primary care to help patients manage chronic conditions and achieve overall better health.

The Goal Behind Boosting Chronic Care Management Reimbursement

The main goal here is to improve patient outcomes while reducing treatment costs. This has become practical in some cases. Though its growth is like the walk of a turtle now, the impacts of this particular change will result in higher patient satisfaction, outcomes, safety, and eventually achieving quality care in the not too long run.

Telehealth usage was equalized after its sudden rise in March 2020, and its usage became triple times larger than it was before the pandemic. It has helped to improve healthcare efficiency, reducing the cost of care among the chronic population remarkably.

The potential value will become higher in the future as healthcare providers became interested in the rise and understood its value and have already started to design and execute CCM plans.

Wondering How CCM Works? Let’s Find Out

The important goal behind designing chronic care management by CMS was to compensate practitioners rendering care to patients in remote conditions, and encourage them to be more patient-centric for those suffering from complex chronic diseases.

As healthcare providers began to engage more with these patients, participate well in their care, and enhance outcomes while reducing costs of treatments, this program became a success by delivering more quality care.

On What Does The Medicare Reimbursement Is Based?

The Medicare reimbursement to providers is solely based on at least 20 minutes of clinical time to each patient per month. Even though it is similar to Principal Care Management (PCM), CCM demands the patient to have two chronic conditions instead of one to qualify.

The conditions eligible under this drive included (but are not limited to) are:

• Diabetes
• Depression
• Cardiovascular disease
• Cancer
• Hypertension
• Chronic Obstructive Pulmonary Disease

In addition to the first requirement, each patient must have an extensive care plan approved and signed by their providers. After that, the providers and their care teams will be eligible for reimbursement.

Chronic Care Management’s Benefits To The Rising-Risk Patients

• Coming to the benefits of CCM, it is very much beneficial to the patients who are in the rising-risk population perimeter.
• The rising-risk population includes patients who may have multiple chronic conditions but are unaware of the conditions and are unwilling or unable to access the care and avoid making the conditions high-risk.
• Using CCM services here is vital for preventing severe health events.
• This is how a large population of the United States population prevents a possible devastating health event that could result in racing into a higher-risk category, from happening.
• The chronic care management services between provider visits create a more person-centered view of a patient’s health.
• This also includes the socioeconomic factors and health behaviors that often go unexposed and notably influence their overall wellbeing.

What Would Be The Future Of CCM?

CMS is pointing out the value the CCM services provide and motivating providers to offer a connective care model between clinical visits, by increasing reimbursements for Chronic Care Management.

These comprehensive care plans boost better patient outcomes, increase the quality of life for people living with chronic conditions and reduce healthcare costs.

The present-day and the future days' health for many people will mostly be impacted by their lifestyle. Chronic illnesses such as diabetes and lung disease for many patients will possibly stem from their lifestyle choices and habits.

The pandemic made people think clearer and make better decisions about embracing healthier behaviors so that they could get a better chance to manage and improve their conditions. 

The increase in the CMS reimbursement opens up a dam of encouragement for providers to use programs that help manage patient care between visits, reduce risk levels and improve both patient and provider outcomes.

Final Thoughts

Chronic Care Management ensures patients get regular checkups without visiting the traditional setup of hospitals and clinics. Ensuring the usage of chronic care management will make practices efficient and incur more patient outcomes.

The new raise in the CCM reimbursement by CMS also encourages the providers to work efficiently by following patient-centric paths.

Welcome to Vozoehr! We are here to help you in this journey to excellence. VozoEHR’s Chronic Care Management ensures your patients follow through with treatments and get whether it is a reminder about a recent prescription or simply having a human connection, which is a crucial one to elder care.

Visit our website for more information on the products we provide to make your practice run smoother and achieve its objectives easily.

“Let’s Make Your Chronic Care Management The Most Efficient One, Together”