2017-05-19 / Health & Wellness

Program helps with chronic care

COMMENTARY /// Medicare
By Greg Dill
Special to The Acorn

If you have Medicare, there’s a good chance you have two or more chronic conditions such as arthritis, cancer, diabetes, heart disease or dementia.

Two-thirds of the 57 million Americans with Medicare have two or more chronic illnesses, which increases the risk of death and functional limitations, decreases quality of life and leads to higher healthcare spending.

Managing chronic diseases can be difficult, to say the least. You often face multiple visits to one or more doctors; you must take multiple drugs at different times on different days; and you have to make extra trips for tests.

At Medicare, we recognize the challenges in managing your conditions, working with your healthcare providers and trying to stay healthy. Two years ago, we added a new benefit called Chronic Care Management, or CCM. This program provides additional payments to doctors and other providers to help you live with chronic disease.

For example, through the CCM benefit your primary-care doctor will help you keep track of your medical history, medications and all the different healthcare providers you see. You’ll receive a comprehensive care plan that outlines your treatments and goals. Additionally, you’ll have 24-hours-a-day, sevendays a-week access to healthcare professionals who can help with urgent needs from the comfort of your home.

To be eligible for CCM services, you must be enrolled in Medicare or in both Medicare and Medicaid, and you must have two or more chronic diseases that are expected to last at least 12 months and place you at significant risk of death, acute exacerbation/decompensation or functional decline.

Other examples of chronic conditions include, but are not limited to, asthma, atrial fibrillation, autism spectrum disorder, chronic kidney disease, chronic obstructive pulmonary disease, depression, heart failure, hepatitis, hypertension (high blood pressure), infectious diseases such as HIV/AIDS, ischemic heart disease, osteoporosis, schizophrenia and other psychotic disorders, and stroke.

Specific CCM services may include: at least 20 minutes a month of chronic care management services; personalized assistance from a dedicated healthcare professional who will work with you to create your care plan; coordination of care between your pharmacy, specialists, testing centers and hospitals; phone check-ins between visits; 24/7 emergency access to a healthcare professional; and assistance with setting and meeting health goals.

How much do CCM services cost? You’ll be responsible for the usual Medicare Part B cost-sharing and may have a deductible or coinsurance/co-pay. However, many people with Medicare have Medigap supplemental insurance that provides wraparound coverage of CCM cost-sharing.

Chronic Care Management means having a continuous relationship with a dedicated healthcare professional who knows you and your history, gives personal attention and helps you make the best choices for your health.

CCM gives you and your loved ones the assistance you need to manage your chronic conditions so you can spend more time doing the things you enjoy.

Ask your doctor about Chronic Care Management and get the connected care you need.

For more information, call (800) 633-4227 or visit the website go.cms.gov/ccm.

Greg Dill is Medicare’s regional administrator for Arizona, California, Hawaii, Nevada and the Pacific Territories.

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