As you may know already, I’ve been working on a series of papers on Medicare’s chronic care management reimbursement program (CCM) for the Medical Product Guide. (Click on ‘resources’ after visiting the Medical Product Guide link if you’re interested — they’re free.)
Talking to practices that have already started working on CCM, along with others that have held back, has been a learning experience. The ability to take on CCM quickly depends a lot on your current practice set-up and, especially, your EHR.
On the current set-up side, if you’re working on or already have set up a medical home (PCMH), and have one or more case managers in place to support it, you may find it easy to use the same staff structure for CCM. Your case managers could become the coordinators for CCM as well — perhaps personally contacting patients and doing the other care management tasks that contribute to the required 20 minutes per month for billing. Perhaps there will be overlap between the PCMH and CCM that could be beneficial — if, for example, you’re looking at a similar mix of conditions, that might allow for some standardized communications or tracking tools. Or perhaps you could add a group visit program that would serve patients from both programs. (A group visit program wouldn’t contribute to the CCM monthly time requirement, since that’s strictly non-face-to-face time, but it still could be well received, and fit with the patient engagement goal of the program.)
On the other hand, if your practice hasn’t yet taken on PCMH, CCM could be a stepping stone. Many primary care practices believe they’re already doing many of the tasks that are meant to be compensated by CCM — they’re just not tracking them, and they haven’t had a way to bill for them, either. That last problem is expressly addressed by CCM — the key is solving the former problem of tracking. EHR vendors vary dramatically in this area. Some have already created dedicated modules that allow for templates for clinical staff contacts to be tracked, and for the time to be calculated. Others have created a foundation, but will need to work with you on customizing. And, of course, some offer nothing yet.
If your EHR vendor has already created tools you can use for CCM tracking, your task in taking on CCM is going to be much, much easier. If you’re a primary care practice with a large base of potential CCM patients, and you haven’t asked your EHR vendor about their capabilities yet, I strongly recommend you do so. You may have read about creating tracking spreadsheets and other manual tools for documenting time spent with CCM patients, and thought it would be too much hassle. If your EHR vendor has created tools you can use instead of creating an external, manual workflow, well, that’s a whole new ballgame for your practice. When the tracking is relatively easy, the reimbursement (averaging about $40/month/participating patient) starts to make a whole lot more sense.
Is your practice working on CCM, or thinking about it? If so, I’d love to talk to you — whatever stage you’re at in the process. Please feel free to reach out to me.