Chronic Care Management
Last year, Medicare began reimbursement for Chronic Care Management (CCM) services. These payments cover non face-to-face care coordination support and 24/7 access to a Comprehensive Care Plan for Medicare patients with 2 or more chronic conditions. CCM addresses one of the common complaints about fee-for-service care: failure to pay for non-acute care coordination between office visits. This translates to the potential generation of $130,000 in incremental revenue for a primary care physician with 250 CCM eligible and enrolled Medicare patients.
Progressive Healthcare implements CCM for a wide range of provider entities, including regional health systems, hospital-owned physician organizations, and independent physician practices. Beginning with our comprehensive, customized assessment for clients that are interested in learning more about CCM, Progressive Healthcare helps clients improve patient care and profits through our CCM Service and Consulting offerings:
Outsourced CCM services via a qualified call center and certified staff. We handle the operational logistics of providing this service and generating incremental margin for the practice.
Proprietary software platform:
Turnkey Comprehensive Care Plan generation and secure portal, accessible 24/7 to patients and authorized members of a patient's care team
Automated time tracking tool to ensure billing accuracy and compliance
Custom patient engagement surveys
EHR interface options include API and HL7
Integration with Transitional Care Management (TCM) and Annual Wellness Visit (AWV) Modules
Staffing support models include full or hybrid labor outsourcing
Centralized scheduling service and appointment reminders
Operational assessments for CCM and related services, plus implementation support
Reimbursement analysis, business planning, and compensation modifications
Regular updates on related CMS rules and billable care management service trends
Integration in an MSSP environment (e.g., maximizing MSSP quality scores, achieving 5-star status for Medicare Advantage plans, generating Pharmacy dispensing revenues)