How to Boost Income With Chronic Care Management


February 26, 2015

In This Article

Issues and Challenges

One thorny issue may arise: If a patient doesn't sign the CCM consent form but phones in for management, follow-up, or activities that cannot be done face to face, will the physicians do those things?

"The decision was tough," says Dr Rosenberg. "The best decision we came to is that if you are eligible for this program and you chose not to sign the consent, then we will no longer offer non–face to face interactions."

Two eligible patients chose not to sign up. Dr Rosenberg pulled their records and showed them how many times they called in for services in the prior year. After seeing the evidence, one patient did sign.

Third Challenge: Getting the Right Staff in Place

Because non–face-to-face follow-up and interactions need to be performed and documented, there is much more coordination and documentation involved, meaning that the office might require different staff members or redeployment of current staff members.

"I hired someone specifically to manage this because of the volume in our practice," says Dr Rosenberg. "I brought in a full-time nonclinical manager who makes sure we are getting the patients' consents and the clinicians are documenting the time spent on CCM. He is mostly doing the infrastructure and is working with our full-time nurse."

Dr Rosenberg adds that the practice has several staff members whose only job is to coordinate patient care activities outside of normal business time. "A majority of those activities qualify under the CCM code. One small obstacle for the Michigan practice is that in that state, medical assistants are not licensed or certified. According to program rules, the person providing the CCM must be licensed or certified. "So we put an licensed practical nurse in charge just to be sure," he says.

Fourth Challenge: Formal Program

Set up a formal care management program for each eligible patient. This program must be recorded and thought out in advance. "So we have been setting up a series of programs," says Dr Rosenberg.


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