With 117 million adults living with at least one chronic health condition, it’s more important than ever that chronic care management (CCM) be supported at assisted living communities.
As Medicare attempts to ensure the sustainability of funding over time, more payment models have begun focusing on caring for the chronic diseases of seniors in a thoughtful way to prevent disease exacerbation and hospitalizations. In 2015, Medicare introduced several chronic care management billing codes that gave primary care medical providers incentive to offer better-coordinated care for older adults who have multiple chronic diseases.
In light of this, let’s take a deeper look at chronic care management, why it’s important, and go over tips for supporting it within an assisted living community.
What is Chronic Care Management?
Chronic care management is defined as services performed outside of regular office visits for patients who live with at least two chronic medical conditions that are expected to last for a year or more. The types of services offered, such as email and phone consultation and around-the-clock access to care providers, are intended to stabilize chronic conditions and help to identify and intervene when a disease exacerbation occurs.
To be eligible for this type of care, an individual’s chronic medical conditions need to place them at risk of death or functional decline. They often suffer from a few of the following:
- Alzheimer’s disease or dementia
- Osteoarthritis or rheumatoid arthritis
- Cardiovascular Disease
- Chronic Obstructive Pulmonary Disease
These conditions tend to contribute to long-term impairment and make up an estimated 71% of all healthcare costs. They’re also the reason that older adults usually seek out assisted living environments. Overall, your residents are likely to benefit from ongoing chronic care management.
Medicare often covers the increased healthcare costs associated with chronic conditions and reimburses qualified providers of chronic care management services for their ability to thoughtfully manage such conditions. Providers and physicians earn an average of $50 per patient per month for assisting in these services.
Why is Chronic Care Management Important?
Chronic care management was designed to help chronically-ill patients receive the care they need while decreasing the financial strain on the healthcare system. In general, recipients of chronic care management have positive things to say about it, including that they have improved treatment, satisfaction, and care coordination.
By working with a physician or provider who has embraced chronic care management practices, you allow many of your residents to age in place. They have more time for education, symptom management, and provider support in comparison to traditional provider-patient relationships. Plus, thanks to the personalized care, they’re able to avoid unnecessary emergency room visits and hospitalizations.
Healthcare practices can also use CCM as another source of revenue since physicians earn a sum of money for every patient each month. However, CCM codes truly provide more incentives for doctors to conduct their jobs in more thoughtful and accurate ways. Instead of seeing as many patients as possible in limited time, CCM’s attentive care planning and support for the needs of patients with chronic diseases allow doctors to practice thoughtful medicine while still being reimbursed for their time and expertise.
Tips for Implementing Chronic Care Management
Despite the positive feedback from recipients of chronic care management, some providers and physicians still resist implementing CCM systems. This is because the system doesn’t always provide upfront investments for adequate staffing or compensation for the additional time that’s necessary to truly assist in complex chronic care cases.
The problem is, there are so many patients who still need chronic care management, and many of them likely reside in assisted living. In order to effectively assist your residents with their chronic disease management, use these tips for supporting physicians or primary care providers who are practicing with a CCM system.
Providers of chronic care management must communicate with each patient monthly for at least 20 minutes. The outreach doesn’t have to be solely performed by the physician, however. Staff members and assistants can reach out as long as they are licensed within the state in which the patient is receiving care.
Work with physicians to explain the ways in which your nurses or medical assistants already provide disease education, care coordination, medication management, and awareness of symptom exacerbation. Your staff can act as an extension of the physician’s own team and can ensure that care is offered at the right time at your community. Some physicians find that making themselves available or having an on-call team to offer phone or telemedicine support 24/7 can drastically reduce the amount of emergency room visits seniors with chronic care diseases need. Reducing those emergency room visits is great for residents as well as physicians and the Medicare system.
Keep Track of Successes and Failures
In order to help minimize staff and physician discontent, administrators of assisted living communities should communicate with physicians who support their residents on a regular basis. If there are areas that require additional staff education, they should be addressed right away. Procedures should be altered until the outcome is positive and successful.
Continue to Train Staff
One of the most important pieces to achieving success in senior living communities is requiring staff members to further their education and training. With the right resources, employees have the ability to become more knowledgeable about their practices, and your residents are able to receive better care.