Care Management Blog

Care management service providers—the companies to which physicians and their practices outsource their programs—are becoming increasingly popular.

Accountable Care Organizations (ACOs) can scale their patient cohort through care management, particularly through the Medicare Chronic Care Management program. But what are the most effective, research-based strategies ACOs use to maximize the value of Chronic Care Management?

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).

The Centers for Medicare and Medicaid Services (CMS) has updated the 2025 Final Rule for Chronic Care Management (CCM). For 2025, there were no major changes to the CCM program rules and regulations in CMS’s Final Rule, but for the first time, Rural Health Clinics and Federally Qualified Health Centers can now bill the CCM CPT codes just like other fee-for-service practices. There are also updated reimbursement rates for the CPT codes.

What is Chronic Care Management? Chronic Care Management (CCM) is a preventive health program that helps patients mitigate their chronic conditions. As covered by Medicare Part B, providers should understand what CPT billing codes matter to the program and how they are used. This can help your organization avoid denied claims and enhance care.

Chronic Care Management supports patients in managing their chronic conditions, preventing future illness, slowing disease progression, and avoiding exacerbation.

In this video, we explore how targeted care management programs, including Chronic Care Management (CCM), Remote Patient Monitoring (RPM), and Behavioral Health Integration (BHI), can make a significant difference in supporting patients with hypertension. Discover how these programs empower care teams to deliver personalized, proactive care, helping patients maintain blood pressure control, improve medication adherence, and reduce their risk of complications.

Medicare’s Chronic Care Management (CCM) program supports patients in managing multiple chronic conditions, slowing disease progression, preventing costly care, and enhancing quality of life. Nurses play a crucial role in this program, particularly for high-risk, vulnerable populations.

An overarching shift has taken place over the past 100 years. It’s picked up speed in the last 20. Medicine has transitioned from a focus on infectious and non-communicable diseases to the prevalence of chronic illness.

Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the US, killing more than 150,000 people each year. COPD is a progressive and incurable lung disease experienced in two primary forms: chronic bronchitis and emphysema.