Chronic Care Management (CCM) represents an excellent opportunity for patients with multiple chronic conditions to receive services designed to improve their care and outcomes. CCM also represents an opportunity for providers to capture reimbursements for these services, many of which they already provide but are not paid for. As the program has evolved over the last few years, more and more providers have decided to begin offering CCM, with many surveys indicating that more than half of primary care providers are now attempting to offer CCM. For any provider who is considering whether to offer CCM services or optimizing their current CCM setup, it’s important to evaluate whether you have the right chronic care management software in place to support your efforts.
Can My EHR Support CCM?
The lack of suitable CCM-supporting software can be a major barrier for providers who have not yet begun to offer Chronic Care Management (CCM) services. Other providers have attempted to offer these services, but find that the lack of technical capabilities within their EHR or current CCM software keep them from providing and billing for CCM. In most EHRs, it is difficult, if not impossible, to track time for CCM activities or track those activities separately from general patient care tasks, or to collaborate with other members of the care team in the ways dictated by program requirements. For the most part, EHRs simply weren’t built with the capabilities necessary for CCM in mind. In 2017, CMS updated its requirements for CCM, saying that certified EHR technology (CEHRT) was no longer required for documentation or for transitional care management documents, though providers will still need to process claims through CEHRT. With that in mind, it may be better to utilize a CCM-specific solution to support the actual delivery of services, and simply ensure that it can securely send and receive any required information to and from your existing EHR.
Chronic Care Management Software
Software solutions created specifically to support CCM activities are likely a better option. With a good chronic care management software solution that extends your EHR without disrupting your existing workflows, you can offer CCM and capture revenue for services you probably already provide, but are not currently capturing reimbursements for. When considering CCM Solutions, some core capabilities that you should look for include:
- Security and Compatibility – the ability to import data on your CCM patient population, and export relevant data as needed, in a HIPAA-compliant manner
- Intelligent Organization and Tracking – provide the ability to assign and delegate patients to the appropriate team member, track time spent on CCM-related services per patient, organize communications between CCM staff and billing providers, and allow care managers to create patient-specific tasks
- Features that Reduce Busy Work – prioritize patients by condition and risk, as well as automatically assign billing levels for each patient based on CMS guidelines
Considerations for Implementing CCM
Before making a decision on which software to use to support your chronic care management efforts, it’s important to evaluate the readiness of your care team for providing CCM services. CCM has much to offer both your patients and your practice, but even the best software solution won’t be enough to support a successful program if your staff is not prepared. Ask yourself:
- Do I have enough qualified patients? CCM requires that the billing provider is the one managing two or more chronic conditions for a patient, and that only one provider may bill for CCM for that particular patient. Consider whether you have the numbers to justify CCM.
- Do I have enough staff? CCM services require clinical personnel, and you need to weigh the demands of CCM against your staff’s current workload. Don’t forget that you’ll need to provide patients with 24/7 access to and continuity of care, per CMS requirements.
- Do we have the necessary expertise? In order to successfully provide and bill for CCM, you must fulfill all program requirements, such as patient education, medication reconciliation, collaboration with other providers, etc. Make sure that you and your staff have an understanding of the program, and the ability to adapt to learn about and adapt to any future changes in program requirements.
- Factor in the overhead. After you’ve considered your staff and their bandwidth, your patient base, and the program requirements, review the costs associated with actually providing the service, such as additional payroll costs, dedicated phone lines, training for employees, and of course, any technology fees. Can you offer the service efficiently enough to turn a profit?
BlueFish Can Help
If you’re looking for someone to partner with for CCM services, BlueFish can help you. Our turnkey service provides licensed clinical staff that act as an extension of your care team, providing the services your patients need while capturing new revenue for your practice.
To request more information about how BlueFish Medical can help you with CCM technology or turnkey CCM services, please fill out the form below.