Hurdles to Caring for Chronic Care Patients

One of the new payment reforms enacted by the Department of Health and Human Services (“HHS”) is the Chronic Care Management (“CCM”) program.  The HHS expects this program to decrease the cost of care for Medicare patients by reducing the utilization of many services, while resulting in an improved quality of care.  There are a few hurdles however, in accomplishing this lofty goal.  Two of the biggest hurdles are: 1) the program’s success depends upon patients being compliant, and 2) the physicians involved must find extra time to administer the program requirements.

SmartCCM just released the results of a survey titled “Challenges in Caring for Medicare Patients with Two or More Chronic Conditions.”  The survey of primary care physicians was completed in late summer by Medical Marketing Research, Inc.  Although the sample size is small, I personally have found the survey results to be consistent with the sentiments of my clients across the country.  Here are some highlights of the survey’s findings:

63% lack the time to provide the extra guidance and reinforcement that these patients require.

56% cite the complexity of managing multiple conditions is a key challenge of the CCM program.

46% were unaware that Medicare reimburses physicians under the CCM program.  (Another recent survey found that two-thirds of primary care physicians were unaware of the CCM program or unfamiliar with its details.)

38% of physicians do not currently contact these types of patients between office visits.

32% state patients are inconsistent with following treatment plans and taking medications.

Perhaps most noteworthy in the survey is that physicians cite a staggering 75% of their applicable Medicare patients are a mere “somewhat” compliant and a pathetically low 5% are “extremely” compliant.  And this is the sort of data that physicians have been trying to tell government officials for years.  Legislators can write thousands of pages of regulations to enforce physician compliance and change their medical behavior, but those regulations cannot enforce patient compliance.

The survey can be found here.


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