This is where you get straightforward answers to the everyday challenges of running a care management program. Got a billing question? A workflow breakdown? A staffing dilemma? Send it in. We answer selected questions in our monthly Q&A column, Dear Care Management Guy. All questions are reviewed by real operators, and many get featured anonymously on the blog to help others facing the same issues or challenges.
Subheader 1 Subheader 1 Subheader 1
True care management stays connected with patients between visits, helps them manage chronic conditions and stay on track with their care plan. Done right, it improves outcomes for the patient, increases revenue for the care provider, and builds patient loyalty.
Care management is for practices that care for patients with chronic conditions and want to deploy a more proactive care strategy for their patients. It’s especially valuable for providers who participate in ACOs and value-based care, but it also works as a natural glidepath for providers who want to evolve into value-based care from fee-for-service models.
Not necessarily. You can start with what you have, but using a purpose-built, interoperable platform makes it a lot easier to scale, stay compliant, optimally engage patients, and generate the additional revenue that you need for long-term sustainability.
No. While Medicare was the first large payer to incentivize for chronic care management (CCM), many Medicaid and commercial payers now reimburse for care management, especially when it supports better outcomes, fewer hospitalizations, and fewer avoidable appointments.
You don’t need extra staff to get started—many practices launch using their existing team. That said, as the program grows, it’s often profitable to build a dedicated care management team to improve patient outcomes and maximize practice revenue.
