Medicare Reimbursement for Chronic Care Management:
Sizeable Revenue, Health Outcome Opportunities

Beginning January 2015, Medicare will pay a flat, monthly chronic care management (CCM) fee to providers coordinating care for beneficiaries with more than one chronic condition. This change will expand the current Medicare payment policy to include non face-to-face management services previously included within payments for evaluation and management (EM) services, amount to about $40 a beneficiary, a sizeable new source of revenue for eligible providers.

The targeted population is also substantial; as a recent news story reported by the Healthcare Intelligence Network (HIN), 87 percent of U.S. adults ages 65 and older have at least one chronic illness, and 68 percent have two or more, the highest rates in a new 11-country Commonwealth Fund survey.

Rick Hindmand But healthcare organizations do not have that much time to prepare for the newly released 2015 Medicare Physician Fee schedule, which finalized the CCM reimbursement. Who can bill for CCM, what constitutes a chronic condition, which patients are eligible to receive CCM services, and the scope of services required were among the issues discussed during Chronic Care Management Medicare Reimbursement: New Revenue Opportunities for Care Coordination, a November 19th webinar, now available for replay. Rick Hindmand, an attorney with McDonald Hopkins, a law firm that advises a nationwide client base extensively on healthcare reimbursement, shared insight on these issues and how to best prepare for this reimbursement opportunity.

In case you missed this webinar, you still have a chance to watch this highly-rated program.

Register to view the conference today or order your training DVD or CD:
http://store.hin.com/product.asp?itemid=4978

You can "attend" this program right in your office and learn: which practitioners can bill for CCM reimbursement; which beneficiaries are eligible for the services; and what CCM services must be provided.

The CCM fee comes to about $40 a beneficiary, a significant revenue source once applied to all patients within a practice. Why the change now? Mr. Hindman speculates that CMS is finally realizing that care management is a crucial component of primary care. But questions and details await future guidance from CMS, and satisfying and documenting compliance with the CCM reimbursement requirements is going to present a challenge for many practices.

But the time and effort is worth it, he says. "With careful structuring, chronic care management can provide the potential to improve the health of their patients, while also providing some significant financial benefits for the practice."

It's so convenient! Invite your staff members to watch the conference. We will send you a DVD or CD-ROM of the conference proceedings or a link to our web site with a username and password. You can log in and view the program right from your computer — any time of the day or night, whenever convenient for you and your colleagues — and benefit from the archived recording of the conference, including the Q&A period.

You'll get to listen to the question and answer session to hear details on: the best way to confirm a patient is available for rendering chronic care management services; how the care plan may be distributed; minimum licensure; and ACOs and chronic care management reimbursement.

To register for the on-demand re-broadcast, download an .MP3 file or order the training DVD or CD-ROM of Chronic Care Management Medicare Reimbursement: New Revenue Opportunities for Care Coordination, please visit:
http://store.hin.com/product.asp?itemid=4978

I hope you find it useful.

Cordially,

Melanie Matthews
Executive Vice President
The Healthcare Intelligence Network

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