A new study shows that a government program for managing chronic care cuts costs while also improving care for the chronically ill.
A federal program for chronic care management (CCM) slows the increase in Medicare costs, helps keep people out of the hospital, and connects them with community-based resources, according to a recent report from the Center for Medicare and Medicaid Innovation (CMMI).
The program results could be replicated by private health plans.
The Centers for Medicare and Medicaid Services (CMS) established CMMI in 2015 to help provide support for patients with multiple chronic conditions in-between their provider visits and episodes of care, creating a new Medicare benefit. The program helps beneficiaries with two or more chronic conditions by providing new “in-between visit” payments to participating providers.
That revenue encourages healthcare providers to focus more on goal-directed, person-centered care planning, and to provide "aging-in-place" resources such as proactive care management, the report explains.
Over 684,000 beneficiaries received CCM services during the first two years of the new payment policy, the report says. They were generally concentrated in the South and had poorer health status than the general Medicare fee-for-service (FFS) population.
“About 19% percent of beneficiaries only received one month of CCM services; however the majority of beneficiaries received between four and ten months of CCM services, on average. Primary care physicians (PCPs) billed for 68% of CCM claims and 42% of CCM billers were solo practitioners,” the report says. “ Individual providers billed for $105.8 million in CCM fees during the first 24 months of the program and, on average, managed about 47 patients per month.”
The report notes, however, that the median number of patients was 10, indicating that the average was skewed by a small number of providers delivering CCM services to many beneficiaries.
Gregory A. Freeman is a contributing writer for HealthLeaders.