Medicare program helps manage chronic illnesses

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  • Written By: Horizon Health
Medicare program helps manage chronic illnesses

Chronic Care Management (CCM) is a Medicare program that helps participants understand and live successfully with their long-term medical conditions.

Under this optional program, patients are actively involved in managing their chronic illnesses. The intent is to reduce unnecessary emergency room visits, readmissions to the hospital, and costs of duplicate testing.

CCM is not an emergency service, but gives patients access to qualified nurses who can assist them with a comprehensive care plan that has been designed especially for them. CCM services are performed independently of a regular office visit. The CCM program offers the following benefits:

  • Each patient can expect a minimum of 20 minutes of interaction time per month with a Chronic Care Management nurse.
  • A dedicated phone line is available for patients to talk to a CCM nurse. If a nurse is not available at the time of the call, a nurse will return the call within one hour.
  • In addition to the dedicated phone line, a Chronic Care Management nurse calls patients every month to check-in and addresses any health-related concerns the patient may have.

Patients can enroll in the service following a discussion with their primary care provider or a CCM nurse. To qualify for the program, patients must meet the following requirements as defined by Medicare:

  • Have two or more chronic conditions expected to last at least 12 months. Examples include cardiovascular diseases, diabetes, cancer, hypertension, asthma, Alzheimer’s disease and related dementia.
  • Have had a face-to-face encounter with their primary care provider within the past 12 months.
  • Provide signed consent to enroll in the program. There is a small cost. Medicare patients can expect to pay $12 dollars a month. If they have secondary insurance, the cost may be covered. Patients can terminate the service at any time. There is no contract.