CareSkore Population Health Management Blog

The Case for Chronic Care Management

Initially introduced in early 2015 by CMS, chronic care management (CCM) was meant to allow providers to manage CCM-eligible patients through non-face-to-face services. But adoption rates have been low. As we mentioned in the first installment of our CCM webinar series, factors dampening adoption include confusion over billing codes, gaps in activities that qualify for reimbursement, and the lack of awareness around CCM itself.

So Why Now?

With half of the U.S. population suffering from chronic diseases, CCM becomes even more compelling. Because of changes implemented by CMS in early 2017, incentives are now aligned with provider priorities of improving clinical and financial outcomes, making CCM adoption a stronger consideration.


Reduced Barriers

With 2017 changes, CMS greatly simplified the CCM process. Compliance requirements were eased while the breadth of covered activities was expanded. For example, before 2017, patients were required to fill out physical consent forms prior to receiving CCM services. Starting this year, that requirement has been relaxed; if you’ve seen the patient within the last 12 months, you can automatically enroll them in CCM.  In addition, care plan development is now reimbursed.

Simplified Billing Rules

Processes have been simplified in the new world of CCM. A CCD is not required to have a structured, specific format for billings. And with less restrictive requirements for billable actions, reimbursements are now easier to understand and obtain.

Improved Care

2017 CCM finally supports providing efficient and effective CCM to your Medicare patients.  By enabling you to provide more comprehensive and appropriate reimbursable care, clinical outcomes for chronic care patients will improve. This improvement will result in reduced avoidable readmissions, better patient engagement and self-care, and increase quality ratings. Your patients win, your caregivers win, and your organization wins.

Embeddable Technologies

While simplified, CCM billing still requires continuously updated understanding of requirements and codes, requiring time that modern health care providers don’t have.  Effective CCM is fostered by effective technology to support workflows and automate processes, allowing you to spend time where you should: on your patients, not the process.  Platforms like CareSkore simplify and automate much of the CCM process, maximizing reimbursements and tracking activity against the latest CMS billing codes while simplifying care plan development and patient engagement.


Are you considering implementing CCM or looking to optimize your current program? Join us for the second installment of our CCM webinar series, Maximizing CCM Outcomes, featuring Dr. Pam Khosla, Chief, Division of Hematology and Oncology at Mt. Sinai Hospital.  Attend this webinar and learn details about the challenges and regulations of CCM and how you can maximize your CCM clinical and financial outcomes with CareSkore. Learn more about our upcoming webinar here.




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