Chronic Care Management (CCM)
We Deliver Value-Based Care Through Our Unique CCM Practice
It’s not easy to transition to value-based care in today’s healthcare environment. With reimbursements transitioning to value-based, providers cannot afford to let patients walk out of the clinic and just hope that they will comply with their care plan.
Providers need a way to monitor patients once they are out of the clinic, to ensure compliance, identify problems before they become problematic, with the ability to intervene early.
Enter Chronic Care Management.
When done correctly, Chronic Care Management extends the reach of your providers by taking all treatments and instructions home with the patient. By remotely engaging patients on an ongoing basis, you ensure compliance, get patients actively involved in managing their own health, as
well as identify health issues before they become problematic.
And with an incentive of $43 per patient per month, practices stand to earn as much as $500 per active patient per year in top line revenue.
The key to a successful CCM program is ongoing patient participation. By leading with a 1:1 care manager-to-patient relationship, and designing an individualized communication schedule to best suit each patient, practices will soon see:
- Patient conditions improve.
- Reduction in ED visits and unplanned hospitalization.
- Improvements in care plan and medication adherence.
- Ongoing patient participation in health management.
But where does an independent practice find the resources to implement such a program – 24/7 nurse on call, spending 20+ minutes of non face-to-face care per patient per month, not to mention the massive documentation requirements, or expensive technology platform requirements?
Finding the right partner makes all of the difference. With Oculus Health’s turnkey CCM solution, The Golden Age of Independent Practice has arrived.
CCM Program Billing Requirements:
There are 49 billing requirements to compliantly bill CPT 99490, that can be filtered into 3 main categories:
20+ minutes of non face-to-face care management
24/7 Nurse on Call
Sharing Care Plan Electronically
If all requirements are met, and proper documentation of all activities conducted, including timing and duration of all activities, are recorded, then a practice can bill CMS approximately $43 per patient per month.
When evaluating the technology and staffing investment necessary to conduct CCM in a compliant manner, independent practices across the nation have either decided:
- Not to implement a CCM program,
- Have attempted to conduct internally with little to no success, or
- Contracted with one of the many CCM Vendors touting a turnkey solution
In most all cases, practices in category 1 are in the best position. Internal programs have proven themselves unprofitable time and time again. CCM Vendors have failed to maintain patient participation, so at the end of the day, all efforts were for nothing.
One of the greatest challenges is that there hasn’t been a success template or evaluation protocol available to providers and administrators.
Based off of success with tens of thousands of patients that continue to participate in CCM month after month, Oculus has developed an evaluation strategy.