What Comes Next for Chronic Care Management?

By Mansoor Khan, CEO, Persivia The Chronic Care Management CPT code (99490) allows providers to collect approximately $42 per qualified patient per month for providing 20 minutes of non-face-to-face care management services to Medicare beneficiaries that have at least 2 chronic conditions. This, as with most new CMS initiatives, has as its ultimate goal the objective of improving patient outcomes and satisfaction. How do we get from this fee- for-service reimbursement to improved outcomes? The Grand Plan CMS has an overall plan that moves the healthcare system into value-based payments at a breakneck speed. In order to get there, CMS has defined 4 categories of payments which are as follows: • Category 1—fee-for-service with no link of payment to quality • Category 2—fee-for-service with a link of payment to quality • Category 3—alternative payment models built on fee-for-service architecture • Category 4—population-based ... read more

Laying the Groundwork for Implementing a Chronic Care Management Program

By Mansoor Khan, CEO, Persivia

First the numbers:

  • 45% of the world’s population is affected by chronic disease
  • 60% of worldwide deaths are caused by chronic disease
  • 4% of the global annual GDP represents the economic burden associated with chronic disease
  • 17% of the US GDP is spent on healthcare, and chronic disease makes up 75% of this expense
  • 80% of chronic disease can be prevented
The numbers are staggering, so what do we do about this? Well, as individuals we can exercise more, eat better and lose weight, but that is not what I am asking. I mean what do we do as a society? Fortunately, the healthcare industry as a whole is working on the problem. However, in this, and successive blogs, I will focus on the path that CMS is taking to address the issue of Chronic Disease Management.

What is CMS Doing About it?

As we all know now, CMS launched the now CPT ... read more