Chronic Care Management (CCM): Building Long-Term Patient and Practice Value

01 Oct Chronic Care Management (CCM): Building Long-Term Patient and Practice Value

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Why Chronic Care Management Matters

Chronic diseases account for nearly 90% of healthcare spending in the U.S., according to the CDC. Conditions like diabetes, hypertension, COPD, and heart disease require ongoing attention—but many practices struggle to manage these patients outside of office visits.

This is where Chronic Care Management (CCM) steps in. By implementing structured, reimbursable care coordination services, providers not only improve patient outcomes but also unlock a recurring revenue stream for their practice.

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Financial Benefits of CCM

• Reimbursable by Medicare & commercial payers: Monthly CPT codes (99490, 99487, 99489) ensure predictable income.
• $42–$94 per patient per month potential revenue (depending on complexity).
• Practices with just 200 CCM patients can add $100K+ annually in recurring revenue.
• Improved patient retention reduces costly hospitalizations and ED visits.

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Provider & Patient Impact

• Better adherence: Medication reminders, health coaching, and regular touchpoints.
• Improved outcomes: Fewer complications and improved quality measures.
• Higher MIPS/QPP scores: CCM contributes positively to quality reporting and value-based care contracts.
• Patient satisfaction boost: Patients feel supported between visits.

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The Risks of Ignoring CCM

• Lost revenue opportunities by leaving billable codes unused.
• Higher risk of poor quality scores in MIPS/QPP and value-based contracts.
• Greater patient leakage to competitors who offer proactive care.
• Potential penalties as payers continue to reward outcomes over volume.

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CCM Adoption vs. No CCM Adoption

Benefits

• Proactive patient monitoring
• Monthly care coordination reimbursements ($42–$90+ per patient/month)
• Improved chronic disease control (e.g., diabetes, hypertension)
• Stronger provider–patient engagement
• Reduced ER visits and hospital readmissions

Risks

• Missed recurring Medicare reimbursements
• Higher risk of uncontrolled chronic conditions
• Increased avoidable hospitalizations
• Lower patient satisfaction & adherence
• Lost competitive advantage in value-based care

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Project Overview: CCM Implementation

Project Type: Patient Care & Revenue Optimization

Project Requirement: Provider participation + patient enrollment

Step-by-Step Process:

1. Identify eligible patients from EMR (2+ chronic conditions).
2. Develop care plan templates and workflows.
3. Train care coordinators and set up monthly outreach protocols.
4. Automate documentation and billing integration.
5. Monitor quality metrics and financial impact.

Timeline: 4–6 weeks setup, ongoing monthly delivery

Expected Result: 10–20% reduction in avoidable hospitalizations, $100K+ annual recurring revenue (per 200 patients)

Setup Fee: Possible one-time configuration fee (EHR integration + workflow design)

Duration: Ongoing program

Requires Access to Provider’s EMR? Yes

Deliverables? Yes – enrollment workflows, care plan templates, billing workflows

Ongoing Subscription Required? Yes – monthly CCM management

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Call to Action

Ready to transform patient outcomes and create a predictable recurring revenue stream?
👉 Get Chronic Care Management (CCM) for Your Practice Below:

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