Chronic care management (CCM) is quickly changing the way we look at long-term health conditions, specifically in major health systems. We’ve seen measurable improvements in patients’ experience and outcomes. But you might be wondering, which conditions qualify for a CCM program?
Even just one of these conditions can put patients at risk of health decline and lead to complications, so comprehensive care aimed at improving your health outcomes is the goal.
This is where chronic care management comes into play.
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The list of conditions that qualify for participation in a chronic care management program is extensive. We'll walk you through some of the most common categories, but remember that this isn't an exhaustive list.
Even if you don’t see your condition listed here, it’s still worth contacting your healthcare provider. They will determine if CCM is right for you based on your specific situation and intervention needs.
We understand this is a large group of conditions, but cancer and related conditions work well with a CCM model. Several types of chronic cancers qualify, including:
CCM can be particularly beneficial for cancer patients, helping manage symptoms, coordinate treatments (of which there are many), and improve overall quality of life during a challenging time. We've seen sizable improvements in each category when involved in a CCM program.
As a more well-known topic under the CCM umbrella, heart health is both crucial and sensitive, and CCM recognizes that. Qualifying conditions in this category include:
These conditions often require ongoing management and lifestyle changes, which is exactly what CCM is designed to support.
There is nothing quite like chronic pain. Patients with chronic pain and mobility issues deeply understand how it can impact daily life and your ability to function. CCM can help manage conditions like:
With CCM, you'll get support in managing pain, improving mobility, and maintaining independence, which is always the goal. This not only helps improve your quality of life, but it reduces the need to rely on home healthcare workers and family.
Vision problems can be particularly challenging for older adults. CCM covers several chronic eye conditions:
Digestive issues are not only uncomfortable, but they can seriously impact overall health. CCM covers conditions like:
With CCM, you'll get support in managing symptoms, adjusting diet, and coordinating with specialists. And that support can be just the thing to truly improve how you feel before and after you eat.
Though often overlooked, mental health conditions are just as important, painful, and limiting as physical health. CCM recognizes this by including conditions such as:
CCM can bolster both patients and caregivers dealing with these complex conditions.
Don’t be surprised if Medicare's list of chronic conditions differs from what we've outlined. We’ve learned the hard way that Medicare doesn’t provide an exact list of qualifying conditions.
Instead, the criteria are based on a set of conditions that need to be met in order to qualify for chronic care management. If you can meet these requirements, then the chances of you qualifying are much higher.
To be eligible for CCM under Medicare, you must have:
1. Two or more chronic conditions
2. These conditions are expected to last at least 12 months
3. The conditions put you at risk of death, acute exacerbation/decompensation, or functional decline
This approach allows for flexibility, recognizing that each patient's situation is unique. Your healthcare provider will determine if your specific conditions meet these criteria and of course Medicare will have to approve of this as well.
In recent years, there have been some changes to chronic care management requirements, particularly regarding documentation. Here's what you need to know:
1. Comprehensive Care Plan: Your provider needs to create and maintain a comprehensive, person-centered care plan that includes all your health issues, not just your chronic conditions.
2. Electronic Availability: This care plan must be available electronically to anyone within the practice providing CCM services, and to you as the patient.
3. Regular Updates: The plan needs to be reviewed and updated regularly, at least annually.
4. Consent: You provide written consent to participate in CCM services. Please know that this can be revoked at any time.
5. Time Documentation: Providers must document the time spent on CCM services each month, with at least 20 minutes required for billing.
These requirements ensure that CCM services are comprehensive, patient-centered, and effectively coordinated among your healthcare team.
Research shows that RPM results in reduced admissions, shorter stays, and few emergency department presentations across 50% of studies. This evidence tells us that when used alongside chronic care management, the combination can be even more effective.
Remote patient monitoring allows healthcare professionals to collect important physiological data like blood pressure and glucose levels. When the information is collected automatically and sent into the monitoring team, it’s easier to identify trends or sudden changes.
The integration of RPM with CCM also improves patient engagement and self-management. Patients become more aware of their health metrics, leading to better adherence to treatment plans and lifestyle modifications.
At Accuhealth, we understand the complexities of managing chronic conditions. That's why we offer a comprehensive CCM program designed to support you every step of the way.
We work closely with your healthcare provider to create a personalized chronic condition management care plan. This utilizes state-of-the-art remote patient monitoring technology that tracks your health in real-time.
With Accuhealth, you'll benefit from:
Patients marked as high risk get extra attention from clinical staff and minimize the risk of unnecessary hospital visits. This is the difference you get with Accuhealth.
Don't let chronic conditions control your life. Take charge of your health with Accuhealth's Chronic Care Management program.
Concierge value-based CCM is just a click away! Contact us today to learn how we can support you in managing your chronic conditions and improving your quality of life.
Accuhealth is proud to feature content from industry-leading experts that contribute in-depth knowledge of Remote Patient Monitoring and Telehealth subject matter to our blog.
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