Use of Chronic Care Management Codes for Medicare Beneficiaries: a Missed Opportunity?

Journal of General Internal Medicine
Rebekah L GardnerEmily Cooper

Abstract

Physicians spend significant time outside of regular office visits caring for complex patients, and this work is often uncompensated. In 2015, the Centers for Medicare & Medicaid Services (CMS) introduced a billing code for care coordination between office visits for beneficiaries with multiple chronic conditions. Characterize use of the Chronic Care Management (CCM) code in New England in 2015. Retrospective observational analysis. All Medicare fee-for-service beneficiaries in New England continuously enrolled in Parts A and B in 2015. None. The primary outcome was the number of beneficiaries with a CCM claim per 1000 eligible beneficiaries. Secondary outcomes included the total number of CCM claims, total reimbursement, mean number of claims per beneficiary, and beneficiary characteristics independently associated with receiving CCM services. Of the more than two million Medicare fee-for-service beneficiaries in New England, almost 1.7 million were potentially eligible for CCM services. Among eligible beneficiaries, 10,951 (0.65%) had a CCM claim in 2015. Massachusetts had the highest penetration of CCM use (9.40 claims per 1000 eligible beneficiaries); Vermont had the lowest (0.54 claims per 1000 eligible beneficiaries). Mea...Continue Reading

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Citations

Jun 20, 2019·Population Health Management·William R MillsDavid Weber
May 5, 2020·Health Affairs·Sumit D AgarwalBruce E Landon
Jul 29, 2020·Journal of the American Medical Informatics Association : JAMIA·Ross W HilliardRebekah L Gardner
Aug 29, 2020·The Journal of Ambulatory Care Management·Mary Kristina WhartonAlessandra N Bazzano
Feb 25, 2021·The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry·Lusine PoghosyanTatiana Sadak

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