More About Chronic Care Management, Principal Care Management, Remote Therapeutic Monitoring, and Remote Patient Monitoring
Chronic Care Management
The industry is very clear regarding the benefits of Chronic Care Management programs to physicians and their patients. We've compiled 3 reports from key industry players to support CCM claims.
What the CDC and NCHS Say
Reason #1: There is a huge need for CCM
Per CMS 2015:
Nationwide: 67.8% of people 65 yrs and over have 2 or more chronic conditions.
Florida: 74.4% of people 65 yrs and over have 2 or more chronic conditions.
What CMS Says
Reason #2: Many patients qualify for CCM
A chronic disease, as defined by the U.S. National Center for Health Statistics, is a disease lasting three months or longer. Per CMS, the chronic conditions are "expected to last at least 12 months, or until the death of the patient" and "place the patient at significant risk of death, acute exacerbation/ decompensation, or functional decline" Link: cms.gov
A chronic conditions list includes but is not limited to:
Addison's disease
Alzheimer’s Disease and Related Dementia
Arthritis (Osteoarthritis and Rheumatoid)
Asthma
Atrial Fibrillation
Autism Spectrum Disorders
Bronchiectasis
Cancer
Cardiac failure
Cardiomyopathy
Chronic Obstructive Pulmonary Disease
Chronic Pain from multiple disorders
Chronic renal disease
Coronary artery disease
Crohn's disease
Depression
Diabetes
Dysrhythmias
Epilepsy
Glaucoma
Hepatitis
HIV/AIDS
Hyperlipidemia
Hypertension
Ischemic Heart Disease
Multiple sclerosis
Osteoporosis
Parkinson's disease
Schizophrenia and Other Psychotic Disorders
Stroke
Thyroid disorders
Ulcerative colitis
“There were 1.9 million Medicare hospital readmissions in 2010. Medicare beneficiaries with two or more chronic conditions accounted for almost all (98%) of these readmissions.”
What Independent Research Says
Reason #3: CCM is a huge source of untapped healthcare cost Benefits
Mathematica Policy Research developed a study in 2017 discussing the impact of chronic care management services on the costs of healthcare. Download the report to see for yourself the power of implementing a program for your patients.
“We found that the average rate of growth in estimated Medicare per-beneficiary-per-month (PBPM) expenditures for CCM beneficiaries relative to the comparison beneficiaries decreased in the 12- and 18-month follow-up periods — $28 in the 12-month follow-up period and $74 in the 18-month follow-up period.”
PCM
Principal Care Management is also known as PCM and its very similar to Medicare’s Chronic Care Management program(CCM) with a few key differences. Under the new PCM codes, specialists may now be reimbursed for providing their patients with one or more chronic conditions with 30 minutes of care management services monthly.
RTM
Remote Therapeutic Monitoring (RTM) enables virtual monitoring of specific health conditions related to the respiratory system and the musculoskeletal system as well as adherence to the therapy (medications) and patient response to the therapy. The goal of Remote Therapeutic Monitoring is more effective patient management using digital medical devices that collect and transmit non-physiological data to the healthcare provider.
RPM
Remote patient monitoring (RPM) uses digital technologies to collect medical and other forms of health data from individuals in one location and electronically transmit that information securely to health care providers in a different location for assessment and recommendations. This type of service allows a provider to continue to track healthcare data for a patient once released to home or a care facility, reducing readmission rates.
Monitoring programs can collect a wide range of health data from the point of care, such as vital signs, weight, blood pressure, blood sugar, blood oxygen levels, heart rate, and electrocardiograms.
