There is significant interest in new Medicare reimbursement for chronic care management (CCM), with 26% of eligible providers having already launched CCM programs and another 23% intending to do so in the next 12 months. These early adopters, however, are struggling with (1) physician engagement, (2) patient education, (3) efficient processes, and (4) regulatory compliance.
These are some of the key findings of the National Chronic Care Management Survey 2015 released by PYA and Enli Health Intelligence. The survey offers new insights for providers and policy makers, as well as vendors offering products and services to support providers’ CCM programs.
“New Medicare reimbursement for CCM offers a bridge from volume-based to value-based reimbursement, as it provides fee-for-service revenue to support development of population health competencies,” said PYA Principal Martie Ross. “For a number of reasons, however, providers are finding it challenging to walk across that bridge.”
“While many had hoped that Medicare would simplify the CCM billing rules to encourage greater participation, the agency took no such action in the 2016 Medicare Physician Fee Schedule Final Rule released on October 30,” Ross continued. “Now, we need to address CCM challenges head on, to ensure patients suffering with chronic conditions have access to these vital services.”
The survey report addresses provider attitudes, intent, and experience with CCM program deployment including:
- Barriers and accelerators to adoption including program design, staffing, supportive technology, and participation in alternative payment models
- The challenge of physician engagement and patient education
- Actual time spent (in addition to the reimbursed 20 minutes), months billed, investments made, and expectations for economic return.
The survey results are based on 309 responses representative of 7,328 entities across enterprise and independently owned ambulatory clinics. The results achieved a 95% confidence level, with a confidence interval of +/- 5.5.
The National Provider Survey on CCM is the latest contribution to a growing library of resources from PYA, including the industry-leading white paper, Providing and Billing Medicare for Chronic Care Management, and subsequent Chronic Care Management Clinical Services Manual.
PYA is a recognized industry leader in CCM support services, assisting organizations in developing effective and efficient CCM programs by translating complicated rules and regulations into practical, straightforward strategies. Enli Health Intelligence has been recognized by IDC Health Insights as the only healthcare IT company providing a complete technology solution for CCM.
** Survey results presented in Webinar on December 3 **
PYA and Enli hosted a webinar on Thursday, December 3rd to present the survey findings and their implications for healthcare providers.
Those interested can view the recording at the following link, Webcast: National Chronic Care Management 2015 Survey Results