CMS launches new payment for chronic care management in 2015
ATLANTA, Georgia—January 21, 2015— On January 1, 2015, the Centers for Medicare & Medicaid Services (CMS) will start paying physicians for delivering care management to their Medicare patients with two or more chronic conditions. For their efforts, eligible providers will be reimbursed at approximately $40 per patient per month – or up to $238,000 per provider per year.
Wellcentive, an industry leader in end-to-end population health management solutions, has the comprehensive care management tools to help healthcare organizations succeed with this valuable initiative. Wellcentive provides tools that not only track patient outreach efforts and all other non face-to-face services, but also integrates them all within a single, actionable patient record.
“Most health systems have a variety of EHRs in play, which makes it challenging to even identify patients that fit the criteria of this initiative,” said Tom Zajac, Wellcentive’s CEO. “Wellcentive’s enterprise-wide solution enables organizations to leverage the entire patient database, delivering a comprehensive view for providers to be able to improve clinical outcomes – the ultimate goal of CCM.”
The biggest change from previous Chronic Care Management (CCM) billing requirements is the renewed focus on patient collaboration and care coordination that comprise non face-to-face time. CMS created the new CPT code, (99490), to reimburse providers for doing what they likely already do – spend 20 minutes per month on non face-to-face care for patients.
“Though the new policy is not restricted to primary care physicians, the move toward care management in this population represents a profound shift in recognizing and rewarding high quality, coordinated care at the primary care level,” added Zajac, “This is because PCPs have the best ability to coordinate care across the continuum and spend much of their time doing so already.”
Data from CMS shows that in 2010, 63 percent of Medicare beneficiaries between 65 to 74 years had two or more chronic conditions. The same year, Medicare spending totaled over $300 billion and increased significantly as the rate of chronic conditions increased.
With the high cost of Medicare spending and its large-scale impact on the U.S. healthcare system as a whole, investing in care management efforts in this population makes sense.
The strength of Wellcentive’s solutions for population health management has been recognized extensively in the last year by prominent industry analysts such as IDC Health Insights, KLAS and Chilmark Research. Wellcentive empowers health systems, providers, payers, employers and other organizations to drive improved outcomes by aggregating data across the continuum of care, applying analytics to identify and risk-stratify patients, and delivering action-based workflow to manage the health of populations.
Built from the ground up to help customers improve clinical, financial and human outcomes, Wellcentive’s population health management technology is cloud-based, scalable, and customized to meet the needs of providers, health organizations and payers. Wellcentive’s technology, insight and services help care teams measure and report performance and implement actionable workflow to drive value-based reimbursement and the transition from volume to value. Wellcentive has gained recognition as a leader in population health management in reports recently released by IDC Health, KLAS and Chilmark. Wellcentive aggregates data from more than 3,000 interfaces, and its solutions improve outcomes for over 30 million lives. Visit www.wellcentive.com; follow us on Twitter, LinkedIn and Facebook; or call 877-213-8456 to learn more.