Why Should We Hire Someone Else To Do This? The Challenges of Successful In-House Chronic Care Management (CCM) Programs
Clinical providers and policymakers have been talking about the quality improvement and cost-saving benefits of chronic disease management for some time. Most medical practices are fully aware of the clinical and cost benefits of Chronic Care Management (CCM); so why aren’t they putting them into practice, or able to successfully yield the benefits when they do? The ongoing challenge for most practices is the operational complexity and investment required (primarily, labor and infrastructure costs) for running your own CCM. Prior to thinking about any CCM program, you must ask – Does the practice have the capacity to make this investment? Or regain any of the investment, if they do? The answer is often, no.
Since the 2015 launch of Medicare’s reimbursement for CCM, the practice of medicine has shifted further towards preventive care and chronic disease management –but a successful, targeted chronic disease management program that identifies, tracks and manages all patients receiving and needing CCM – goes way beyond the scope and time available for a practitioner, or the resources of many practices and hospitals – and therefore, can be very difficult to accurately, or successfully, implement. For more information about CCM click here.
Why In-House CCMs Often Fail:
Most medical practices and health systems know that managing chronic conditions improves health outcomes, decreases the cost of care and potentially increases revenue. But how do you provide high-quality CCM without losing money for the practice? And how do you scale the program to fully capture and benefit all eligible patients? And finally, how do you do that while reducing your own costs, increasing your profit and not burdening your staff and systems with the high demands of accurate and effective implementation? You can’t improve quality metrics or achieve savings without successful systems, technology, staff and expertise. The majority of practices don’t have the in-house expertise to create the infrastructure, or sufficient staffing to utilize these systems and tools.
Program adoption and utilization is lacking: Many practices are not trying CCM, or are not aware of reimbursement.
For practices that do try – many cannot reach patients, struggle with staff training, attrition and patient churn, and are unable to scale their programs, because of:
Operational complexities: Building and scaling a successful CCM program takes time, money, software and staff.
Sophisticated Software and Staffing: It’s very difficult to run or scale a successful CCM program without highly sophisticated software and sufficient CCM staff with a lot of training and expertise.
Labor costs: Creating and running a consistent and successful CCM program requires significant amounts and kinds of labor at every turn – examples include, labor to develop systems and software; labor to implement programs; labor to train the staff, building buy in and trust; labor of consistent, clinically savvy staff to identify, track, enroll and follow up of with patients.
The heavy burden and majority of costs are woven into all of the operational requirements involved in running a successful CCM program. Without substantial investments in people, technology and time, practices set themselves up for failure when they try to do it themselves.
To address the clinical and operational challenges associated with building a successful, profitable CCM program, many providers are integrating their CCM program management with companies specializing in delivering chronic care management programs, like Medsien.
Partner with the Experts – Medsien is Ready
At Medsien, we are uniquely qualified to handle the personal, the medical and the technical. We strive to work together as partners, providing simplified services as an extension of your practice or health system, rather than as an outsourced CCM program. We have developed a hybrid model with unique software and full staffing capabilities that can help your practice, hospital or health system provide CCM to more patients, yielding greater outcomes and increased revenue. Our sophisticated solutions provide everything required to overcome the operational complexities of running a CCM program in-house. From eligibility to monthly billing, we work to help you scale your CCM quickly and efficiently, with no additional staffing, operational or financial burden.
We are experts in value-based program development, but also have some of the most cutting edge and leading expertise in software development. Our unique and highly sophisticated software systems combined with our superior software expertise, allow us to provide full service, (customizable) turnkey CCMs, that can be implemented and scaled quickly – at no burden or cost to you.