decisionhealth Newsletters, Coder Pink Sheets - 2018 Issue 5 (May)
Add practice revenue, get a leg up on MIPS by wrapping in CCM services
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Article Overview
This article discusses chronic care management (CCM) as a practice strategy for supporting revenue, care coordination, and performance under Medicare quality-reporting and value-based programs, including MIPS. It is aimed at physicians, practice managers, billing staff, and care management leaders who want a broad understanding of CCM adoption, program setup, staffing considerations, patient selection, and the general types of CMS guidance and billing topics involved.
Why This Topic Matters
It helps practices evaluate whether CCM is relevant to their workflow, staffing, and Medicare participation goals while understanding why the service is often linked to value-based performance and operational planning.
Article Sections
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Revenue, cost, and value-based performance
Introduces the relationship between CCM, practice economics, and Medicare value-based programs. Covers the broader context of cost reduction and performance measurement.
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Build a system to succeed
Outlines practical considerations for establishing a CCM program within a practice. Addresses operational planning, staffing, patient targeting, and implementation challenges.
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Resources
Lists supporting external reference materials related to CCM and Medicare guidance.
What You Will Learn
- How CCM fits into practice revenue and cost-management discussions
- Why CCM is connected to Medicare quality-reporting and value-based programs
- What broad operational elements are involved in launching a CCM program
- What staffing and patient-selection considerations practices may evaluate
- Which general CMS and external resources are referenced for further reading
Who Should Read This
- Physicians
- Practice administrators
- Billing managers
- Care coordinators
- Revenue cycle professionals
- Primary care practices
Codes Discussed
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