If a patient has Medicare or is dually eligible (Medicare and Medicaid) and lives with two or more chronic conditions that worsen their quality of life and put their health at risk, chronic care management (CCM) services can help connect the dots to improve a patients overall quality of life. Examples of these chronic conditions include—but are not limited to—arthritis, cancer, depression, diabetes, and high blood pressure. Services may include:
CCM allows you to better manage yourcare and spend more time focusing on your health by helping you work toward your health and quality of life goals. CCM can help you avoid trips to the emergency department, falls, or worsening health.
Coordinated care means you willreceive personal attention and help from a provider you know and who knows about your health conditions and helps to keep you healthy. You will receive acomprehensive care plan to support your goals, along with more frequent communication and support between visits, resources, community services, and other educational information.
As a CCM participant, a patient must give written or verbal consent to ensure they are involved with their care planand aware of any applicable cost sharing. They will need to provide informed consent only once unless they switch to a different CCM practitioner, and they can disenroll from CCM services at any time by speaking to their health care provider.
A patient should also be aware thatonly one health care practitioner and/or hospital can provide CCM services eachcalendar month.
Talk to your patient about CCM services and their coverage. The usual cost-sharing rules apply to CCM services, so they may be responsible for the usual Medicare Part B cost sharing (deductible and copayment/coinsurance) if they do not have supplemental, or wraparound, insurance. Most dually eligible individuals are not responsible for cost sharing. Medigap plans provide wraparound coverage of cost sharing for CCM, and many individuals have Medigap or other supplemental insurance.
