Implementing Value-Based Care With Chronic Care Management (CCM)

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The healthcare landscape is changing and moving away from its traditional practices. In its quest of becoming more patient-centric, it has adopted an holistic approach to make the most out of what they are offering.
For instance, the trend of holistic value-based care has caught the attention of many patients, especially those who are suffering from chronic conditions. Since treating chronic conditions is a collaborative effort with longer diagnosis and treatment time value-based treatment was brought into existence.

Though implementing value-based care in traditional practices is quite difficult, in the modern era where digitization of healthcare practices is on a swing, chronic care management (CCM) software can be the ideal solution.

But now the question, ‘how to implement CCM program for value-based care?’ might keep you thinking at night. Well, let’s deep dive into the implementation of value-based care with chronic care management software and explore the benefits of CCM for value-based care.

The Value-based Care Challenges

Before starting with the implementation of value-based care with a chronic care management program, let’s look at the challenges that come in providing value-based care.
The major challenge with implementing value-based care is the shift from fee-for-service. Since most healthcare providers are used to this care model, the shift to value-based care can be difficult for many. Moreover, to enable value-based care you need to take a holistic approach and make your healthcare practice driven with data.
Patient’s health vitals with respect to their conditions should be tracked, recorded, monitored and set health goals according to it. Along with that, other performance metrics that are used in value-based care are patient engagement rate, health outcomes and cost reduction for patients.
Only after you have enough data can you provide value-based care of the highest quality. Since fee-for-service takes a huge toll on a patient’s finances everytime they have a consultation, in value-based care, the patient needs to pay only when they see and experience improvement in their health condition.
Telehealth and CCM software here can help in smooth transition from fee-for-service to value-based care. Since the software will keep a track of every care activity and patient’s health vitals, performance metrics such as hospital readmission, satisfaction rate, etc., can be recorded, creating a win-win situation for both patients and providers.
All these benefits of CCM for value-based care are quite hard in traditional practices, which can hugely impact the reimbursements of the practice.
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Chronic Care Management - The Catalyst in Your Value-based Care Equation

If you’re still reading this, then it must be clear that providing value-based care in traditional healthcare settings is as challenging as it gets. However, there is where the chronic care management program comes to the rescue. Since it includes virtual consultation, drives bata-backed practices and requires collaborative effort in care planning and goal setting, it naturally takes a holistic approach covering all the aspects of value-based care.
Let’s understand this with an example. For instance, there is a patient suffering from type-2 diabetes who enrolls into the chronic care management program, then the care manager will understand the situation of the patient and taking all the needs and preferences of the patient into account will develop a care plan and give medications that will fasten progress.
Along with that, the patient will also be provided with education material to educate the patient about their condition. This will not only raise awareness in the patient about their condition and the suggestions will help him make the required lifestyle changes. Along with that, the daily follow-up calls will ensure the patient is adhering to the treatment plan and medication which will reduce complications and improve health outcomes over the period of time.
This is how by increasing patient engagement with CCM you can improve patient outcomes and provide value-based care. Along with that, important practice performance metrics can also be gathered from the chronic care management software which can further help the practice in improving their practice and ultimately increase value-based reimbursements.

Implementing a Successful CCM Program

To answer your earlier question of ‘how to implement CCM program with value-based care?’ Here’s a 5-step brief guide to help you with. However, to begin with the program, the first thing you need is a chronic care management software that can help you in its successful implementation.

1. Program Preparation: The first step to implement CCM program is to understand the CCM program landscape and the conditions the CMS have put in placincreasing patient engagement with CCMe for success value-based reimbursements. After that you need to have a CCM care team in place to start providing value-based care services and align your clinical workflow with the chronic care management software and other technological landscape.

2. Patient Identification & Enrollment: Once the preparations for the program are completed, the next step is to identify patients who are eligible to be enrolled in this program. For this the CMS requires a patient with at least two chronic conditions which are likely to last at least a year or lifetime. Once that is done, you need to educate patients about the program and get their consent to start providing value-based care.

3. Provide Value-based Care: After the patients are enrolled into your CCM program, develop personalized care plans for each patient with goals, interventions and communication strategies. Along with that, you should also train your team with proper protocols and other necessary things which are usually involved in providing value-based care.

4. Patient Engagement and Care Delivery: Maintain regular communication with the patients through calls, telehealth consultations, secure messaging and remote monitoring of patient health condition. Along with that, develop and implement strategies to keep the patient engaged in their care journey through patient education and other self-monitoring tools.

5. Billing & Value-based Reimbursements: Last but not the least, follow the coding and billing procedures for CCM services according to payers guidelines and develop a system to track and manage program revenue for your practice.

Ways CCM can Enable Value-based Care Success

Despite the lucrative benefits of the chronic care management (CCM) program, there might be still speculations about how CCM can ensure providing effective value-based care. So, here are three ways in which CCM enables value-based care success:

1. Improve Patient Satisfaction & Engagement: Increasing patient engagement with CCM is one of the core USPs of the chronic care management program. Through education material, secure communication challenges and tracking of patient health CCM programs can help you in improving patient satisfaction rate and also patient engagement in their care journey.

2. Enable Better Patient Health: The CCM program is designed in such a way that enables providers to not only provide better health services but also keep a track of their health for proactive care and improve their health outcomes.

3. Maximize Clinical Efficiency: One of the major benefits of CCM for value-based care is that it enables the clinic to function at maximum efficiency with a dedicated care team looking after patients enrolled in the CCM program and other staff looking after the day-to-day functioning of the clinic.

Conclusion

In a nutshell, the chronic care management program enables providers to adopt a holistic way of care which helps them in delivering better quality of care and focus more on patient outcomes rather than just on service. Taking the traditional healthcare service away from the fee-for-service model, it enables value-based care for patients and creates a win-win situation in this complicated healthcare landscape.

Frequently Asked Question’s

Value-based care in chronic care management represents a healthcare delivery approach that focuses on offering more services to ensure improved patient outcomes, all while managing costs effectively.
In a Chronic care management program, value-based care can be effectively measured by analyzing medication adherence, patient engagement, reduction in emergency visits and hospital readmission, and improved patient outcomes.
The reimbursement model commonly associated with va8lue-based chronic care is Pay-for-Performance (P4P), where providers receive additional financial rewards for achieving specific quality benchmarks related to chronic disease management.
Patient satisfaction is directly related to the value-based care provided to the patient, which signifies the success of the program.
Technological innovations like Remote Patient Monitoring, Chat Bots, real-time communication channels, Telehealth platforms, healthcare interoperability, etc., support value-based care in chronic care management.

Some of the challenges you might face when transitioning to value-based chronic care are:

  • Data limitations and interoperability
  • Financial risk and incentives
  • Workflow integration and technology adoption
  • Administrative burden and reporting requirements
  • Lack of collaboration and care coordination

However, the best way to address these challenges is to provide effective training to your staff and choose the right CCM software for the successful implementation of the program.

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