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Increasing Profitability While Providing High-Quality Chronic Care Management (CCM)

Providing a high level of care for patients while also keeping your practice profitable is often a challenge that requires you to find a balance. While incorporating high-quality  chronic care management (CCM) will help improve patient outcomes and boost their satisfaction, it can also deplete essential resources and time if not set up and managed efficiently.

As a coordinated and comprehensive care approach, CCM requires significant infrastructure and staffing, which can directly impact your practice’s profitability. The initial and ongoing investment required without a noticeable increase in financial returns is a  dilemma faced by many practices today.

Yet, it doesn’t have to be an “either/or” situation. Providing high-quality chronic care and maintaining the ability to make a profit is possible.

Start by identifying what is holding you back from creating a CCM program for your patients or what is making your current CCM program unprofitable. The most common causes include inadequate staff, low patient enrollment, overly complicated and time-consuming Medicare billing requirements, and a lack of adequate technology to facilitate a CCM program.

With this information in mind, consider the following ways to increase profitability while providing high-quality CCM for your practice.

Increase Patient Enrollment by Taking a More Personal Approach

Attracting more patients to participate in a CCM program can boost the financial performance of your practice. Yet, many patients may be hesitant due to the additional co-pay requirement or an initial distrust for a new program that goes beyond regular office and lab visits.

To help alleviate these concerns, have the primary care provider initiate a conversation to introduce the CCM program and its benefits. Promote awareness and encourage participation by educating the patient about the benefits, such as:

  • Access to care plans 24/7
  • A reduced need for in-office appointments
  • A decrease in ER visits and hospitalizations
  • A proactive approach to improving their long-term health and quality of life

You can still hand out documentation and follow up by phone afterward. However, by initially taking a more involved, personalized approach, you can win over your patients’  trust more readily.

Assign a CCM Coordinator or Manager

Your staff may be overworked and unable to adequately keep up with all the necessary requirements of a CCM program in addition to their other work.

Effective CCM programs require staff participation, including making phone calls, sending emails, documenting time spent on these, and other essential tasks. Medicare recognizes the value of Chronic Care Management. However, filing for reimbursement is time-consuming, requiring monthly billing and documentation. Internal staff  must interact with patients, educating them about the program and answering questions whenever they arise.

To alleviate the stress and strain on your existing staff, designate one staff member or hire a new one to manage your in-office CCM program. Train this staff member to efficiently provide care management, create accurate documentation, and maintain billing. A good CCM service provider can provide these services, often at a lower cost than hiring an in-house staff member.

Bill More Efficiently for CCM Services

To generate additional revenue, understand how to bill more efficiently for CCM services for reimbursement. You will need to start by aggressively documenting the time spent on CCM. Provide this to Medicare, knowing all the CCM codes and their service parameters, rates of pay, and required usage.

Understanding the entire billing process, the Medicare reimbursement formula, and any other requirements can result in greater efficiency, it takes less time for your staff, and will ensure a higher likelihood of payment.

Incorporate Efficient Tools and Technology

Streamline your CCM process and improve the workflow and efficiency by incorporating tools and technology beneficial to your practice. To receive reimbursement from Medicare, all participating practices must provide patients with access to care plans 24/7 via an EMR (electronic medical records) system. Much consideration is needed to build the necessary infrastructure.

Yet, depending on the size of the practice, the investment required for adding an adequate technology platform to facilitate CCM workflows can challenge any financial benefits you may receive. If so, you might want to consider the benefits of outsourcing.

Partner with a CCM Service Provider

Instead of investing in an advanced technology platform and hiring a program manager for your practice, consider outsourcing to a qualified CCM service provider. Successful CCM service provider should have an extensive background in Remote Patient Monitoring

Collaborating with a CCM service provider can save you both time and resources, and it can improve the overall patient experience. It frees up internal staff to focus on caring for patients and keeping the practice running smoothly, efficiently, and profitably. Working with a service provider also eliminates the need to recruit, hire, and train qualified staff to manage the program and to be in charge of accurate documentation and billing.

The process of enrolling and implementing your CCM is similar to adding remote patient monitoring (RPM) to your practice. For example, enrolling with a reputable service provider, like Medek RPM, will provide you with the tools and dedicated support you need to be successful. Medek RPM  also conducts patient eligibility assessments to help identify patients and communicates directly with each identified patient. In addition, we take over the billing for you, including optimizing billing for CCM codes to maximize your reimbursement.

Learn More About the Benefits of Collaborating with Medek RPM Today

With the help of Medek RPM, your practice can provide patients with high-quality support and care for managing chronic conditions while also increasing your operational efficiency and revenue potential. Our goal is to manage your RPM program details and support your patients, freeing up more of your time to build and maintain your medical practice.

Start a conversation with a Medek Representative to see how their experience in Remote Patient Monitoring equips them for success with Chronic Care Management. 

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