Care Management Blog

One of the powerful aspects of Medicare care management programs is that some are designed to work together. A primary example is offering Chronic Care Management (CCM) alongside Remote Patient Monitoring (RPM).

Over the past 20 years, the number of chronic diseases has increased steadily. Today, 42% of adults have two or more chronic conditions, and 12% have at least five. The number of adults over 50 with at least one chronic disease is expected to increase from 71.5 million in 2020 to 142.6 million by 2050.

Managing diabetes can be challenging, but with the right care management programs, patients can take control of their health and achieve better outcomes! In this video, we’ll dive into how Chronic Care Management (CCM), Remote Patient Monitoring (RPM), and Behavioral Health Integration (BHI) can work together to support diabetes patients on their journey to a healthier life.

Over a decade, the Centers for Medicare & Medicaid Services (CMS) tested various value-based innovation models focused on improving primary care. Models like CPC, CPC+, and Primary Care First demonstrated that “comprehensive primary care can lead to reductions in emergency department and hospital visits while better meeting patient needs.”

The Centers for Medicare & Medicaid Services (CMS) launched Z codes in 2015. They are a set of ICD-10-CM codes that identify non-medical factors that may affect a patient's health status or ability to fully benefit from treatment. They were released for billing and research purposes, yet no reimbursement is associated with their use.

The Centers for Medicare & Medicaid Services (CMS) created the Shared Savings Program (SSP) to encourage physician groups, hospitals, and other healthcare providers to support more coordinated, high-quality, and cost-effective care.

When deciding to start a new care management program or scale an existing one, there are many questions to answer, including:

Care management program success depends on keeping patients actively enrolled in the program until they achieve their health and wellness goals, their health risk decreases, and they can confidently self-manage their chronic conditions. When this happens, they can graduate from the program and return to traditional disease management.

Health systems are looking for ways to improve care outcomes and patient experiences while building cash flow and enhancing pay-for-performance.

The Centers for Medicare & Medicaid Services (CMS) has released the proposed rule for its 2025 Medicare Physician Fee Schedule.