Evaluation of the Diffusion and Impact of the Chronic Care Management (CCM) Services: Final Report

Evaluation of the Diffusion and Impact of the Chronic Care Management (CCM) Services: Final Report

Published: Nov 02, 2017
Publisher: Washington, DC: Mathematica Policy Research
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Authors

Claire Wilson

Neetu Jain

In January 2015, the Centers for Medicare & Medicaid Services (CMS) introduced a separately billable non-face-to-face Chronic Care Management (CCM) service. The goal of CCM is to improve Medicare beneficiaries’ access to chronic care management in primary care. Over 684,000 beneficiaries received CCM services during the first two years of the new payment policy. These beneficiaries were generally concentrated in the South and had poorer health status than the general Medicare fee-for-service (FFS) population. About 19 percent of beneficiaries only received one month of CCM services; however the majority of beneficiaries received between four and ten months of CCM services, on average. Primary care physicians (PCPs) billed for 68 percent of CCM claims and 42 percent of CCM billers were solo practitioners. Individual providers billed for $105.8 million in CCM fees during the first 24 months of the program and, on average, managed about 47 patients per month. However, the median number of patients was 10, indicating that the average was skewed by a small number of providers delivering CCM services to many beneficiaries. This translates to about $300 in CCM fees per month for providers furnishing CCM services to 10 beneficiaries.

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