Care Management Blog

The ThoroughCare team was excited to attend the conference of the National Association of Rural Health Clinics (NARHC) in San Antonio Texas last spring. The conference represented over 400 participants from Rural Health Clinics across the United States. We noticed 

Care Coordination and Wellness programs, with goals of improved health, better care and lower costs, continue to expand. Unfortunately, these programs lag behind in many rural communities. But programs like Chronic Care Management (CCM) are tailor-made for the rural population. Here are 6 reasons Rural Health Providers need CCM:

Since the inception of CCM in 2015, the rules have been updated annually.  These changes are typically the result of an open-comment period where CMS listens to feedback and suggestions.  For the most part, the changes have been positive each year. Continue reading to find out about the changes for 2019. 

Physicians and their staff have long been advised of the quality of life improvements afforded through the implementation of care management, wellness and prevention programs for its Medicare patients.  But do they really understand what is to be gained financially?  

Happy December! I can’t believe we are almost into 2019. What happened to 2018?

Hello Everyone and Happy Belated Labor Day!  We hope everyone enjoyed the long weekend as the summer winds to completion (I for one am not thrilled, but hey, at least we have football!) In this blog, I'll cover an area that is ripe with opportunity for improving overall quality of life through expanded care coordination efforts: Behavioral Health. Estimates show that approximately 65 million Americans are afflicted with a behavioral health condition, 13 million of whom are Medicare beneficiaries. The projected health care costs associated with these conditions is $57 billion - yes, that is billion with a “b” - a staggering amount that puts the behavioral health-related spend on a level playing field with cancer. For many years, and particularly within the Medicare community, these conditions were rarely addressed.  Older adults, mostly affected by preexisting chronic conditions, generally look to their primary care physicians to provide treatment. Unfortunately, this community of providers were limited in their ability to identify – or even acknowledge – a patient’s behavioral issues, as the diagnosis and management of these issues was restricted to settings that specialized in mental health.  This resulted in upwards of two-thirds of qualified Medicare beneficiaries failing to receive the appropriate care. The downstream impact on physical outcomes, in hindsight, is rather obvious – for example, a depressed patient may not feel motivated to take the actions recommended by their doctor in association with their chronic physical ailment.  If we intend to effectively address the physical conditions, we first need to effectively address the behavioral ones.

Note:  This article was originally written in January of 2018.  It has been updated on January 3, 2019 for the new 2019 Medicare Deductible.  With the start of a new year, practices are ramping up their CCM programs.  Patients are still working towards their "New Years Resolutions" of being healthier.  Plus, with an increase of "sick visits" during these winter months, it's the perfect time to promote Annual Wellness Visits and Chronic Care Management (CCM).

When Medicare began the CCM (Chronic Care Management) program in 2015, practices everywhere benefited from profitable new incentives for managing their chronic Medicare patients.

On November 15, 2016, Medicare published their official changes to the Chronic Care Management (CCM) program beginning on January 1, 2017.  There are significant new changes which will enhance the program and make it easier for practices to enroll their patients. As you know, ThoroughCare's CCM Software allows practices of any size to implement an efficient CCM program. So here's our summary of the new changes: