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9 Factors When Choosing a Vendor for CCM

With CMS’ implementation of the Chronic Care Management (CCM) program, more and more providers have realized to properly conduct the program, outside assistance may be needed. In particular, small and medium size practices may struggle with the day-to-day operations of CCM, including consistently calling enrolled patients every month.

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Seeing the potential profitability of the program, physicians are considering which approach to CCM would best benefit the practice as well as the patient. Besides hiring additional staff, which can be costly, many practices have hired third-party companies to manage the monthly calls.    However, many doctors complain that some of these companies are actually hindrances to improved patient care, increasing paperwork, fragmenting care, and lacking the personal feel of a true doctor-patient relationship.

Signing up with a third-party company can actually derail the benefits CCM is intended to create. When CMS envisioned CCM, they hoped for the development of a unique and personal care plan under the primary care physician, as well as monthly, personal non face-to-face follow-ups. When physicians sign up with a third-party, in particular with larger companies, this personal touch is often negated by follow-ups from enormous call centers, sometimes thousands of miles away from the patient.

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Additionally, patients often receive calls from different people each time, further distancing the relationship the program is intended to create. This process can alienate patients, and make them feel as if the provider simply doesn’t have the time to care about their health, and is choosing to outsource it.

However, again, CCM implementation requires advanced technological infrastructure as well as the right qualified clinical staff. How can a provider know they’ve made the right choice? Here are some factors every doctor needs to consider:

  1. The vendor has the appropriate clinical staff with the right care coordination experience

  2. The vendor has a continuous education program for their clinical staff

  3. The vendor provides the necessary technological infrastructure to integrate care notes into EHR

  4. The vendor has consistent time tracking for CCM activities

  5. The vendor provide an on-boarding service to enroll qualified patients

  6. The vendor has developed extensive disease based protocols for meaningful interaction with enrolled patients

  7. The vendor has the knowledge base to integrate patient clinical data on the CCM platform

  8. The vendor has the technological structure to share necessary data with all a patients’ physicians

  9. The vendor has positive reviews with their current clients

To re-emphasize, when operated correctly, CCM should both improve care for patients,  with multiple chronic illnesses, reduce cost to Medicare and provide financial incentives to the provider for that care. Since the day-to-day requirements for CCM can be a burden on a physicians busy schedules, an appropriate measure to insure consistent patient satisfaction may be to hire a third-party vendor. Just make sure you choose the right one!


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