Upstate SC News

On April 25, Congressman Jeff Duncan and Congressman Suzan DelBene reintroduced the Chronic Care Management Improvement Act. This bipartisan legislation will facilitate better chronic care management (CCM) for Medicare beneficiaries by eliminating cost-sharing for chronic care management services under Medicare. Chronic care management is underutilized because of the current Medicare payment structure even though it is shown to lower patient costs and result in better health outcomes.

“Chronic care management is a meaningful, commonsense way to lower patient costs and is a conservative solution to provide a higher standard of care for seniors with chronic care needs,” said Congressman Jeff Duncan (SC-03). “As our national debt grows and our population ages, investing in the Chronic Care Management Improvement Act will ultimately save money for both seniors and the American taxpayer.”

“Removing barriers to chronic care management is key to lowering health care costs and delivering better results for seniors,” said Congresswoman Suzan DelBene (WA-01). “Chronic health conditions account for 90% of national health care spending, yet too few seniors are receiving these vital services. Dropping cost-sharing requirements would increase access to these services for more seniors.”

Background:

CCM is billed monthly and is performed continuously. A Mathematica report from November 2017 revealed government expenditures were significantly lower for beneficiaries who received CCM services compared with those who did not. The report showed each beneficiary saw a decrease of $28 per month compared with those without CCM. Over 18 months, savings increased to $72 per month compared to those without CCM. Even though care management can help improve patient outcomes, this service is underutilized. According to HHS, of the 22 million eligible Medicare beneficiaries, only 882,000 patients (4% of patients) received CCM services in the first two years of the payment policy.

Examples of CCM Services include:

1. Recording of patient information using certified EHR technology;
2. Providing 24/7 access to providers;
3. Designating a team member to schedule future appointments;
4. Systematic assessment of the patient’s medical, functional, and psychosocial needs;
5. Medication reconciliation and adherence;
6. Creation of a comprehensive care plan;
7. Transmission of documents to ensure continuity of care during care transitions;
8. Coordination with home and community-based providers; and
9. Enhancing communication options (secure messaging, etc.).

Original source can be found here.