With Medicare’s shift to value-based care, the Centers for Medicare & Medicaid Services (CMS) has approved monthly chronic care management (CCM) reimbursements for providers. Chances are your practice is already managing Medicare beneficiaries with two or more chronic conditions, and the truth of the matter is – it can be really challenging. Add CMS requirements to the mix and it can feel impossible. Despite the hurdles, it is within your reach to manage care more efficiently and effectively while meeting CMS requirements.

This blog post shares some of the secrets to continually improving your CCM efforts, while meeting evolving regulatory demands.

First, some CMS history for context.  

  1. Effective January 1, 2015—CMS reimburses providers approximately $41/month to deliver 20+ minutes of non-face-to-face care coordination for Medicare beneficiaries with two or more chronic conditions
  1. Proposed July 1, 2016 – CMS proposed:
    • Two additional billing codes for Complex CCM
    • Removing on-site staffing requirements for RHC/FQHCs
    • No initiating visit is required for patients seen in last 12 months
    • Add-on G-Code for initiating visits

So, how can you cope with these changes while improving care outcomes?

NextGen Healthcare has announced a partnership with CareSync, an industry leader in CCM since 2011.
The turnkey CCM solutions we offer via CareSync can help you:

  • Increase patient satisfaction
  • Better access the full clinical picture
  • Increase revenue
  • Improve health outcomes
  • Prepare for MACRA changes

What is the care coordination process via CareSync?

value based care






How can providers benefit with CareSync?

  • Quality – high-quality measures are related to patient outcomes, appropriate use, patient safety, efficiency, patient experience, and care coordination. CareSync helps you achieve better care outcomes.
  • Cost – clinicians who deliver high-quality care achieve better performance, which means that clinicians with the most points have the most efficient resource use. CareSync can help you increase revenue, while lowering costs.
  • Clinical Practice Improvement Activities (CPIA) – clinicians are rewarded for clinical practice improvement activities focused on care coordination, beneficiary engagement, and patient safety. With complete CCM coverage, CareSync has you covered.

The above benefits align well with MACRA compliance and the four weighted criteria under MIPS (Merit-Based Incentive System).

Stay informed. Take out the guesswork.

Your “Advancing Care Information” base score is made up of six proposed objectives and their measures: Protecting patient health info, patient electronic access, coordination of care through patient engagement, electronic prescribing, health information exchange, and public health and clinical data registry reporting. Your performance score emphasizes patient care and information access.  Don’t leave your Medicare reimbursements to chance. Sign up for an upcoming webinar to learn how our CareSync partnership can help you take the guesswork out of complicated CCM requirements, navigate CCM with ease, and prepare for MACRA.