About a decade ago, Medicare started a program to help the two-thirds of beneficiaries suffering from chronic conditions by paying additional monthly fees to doctors to coordinate their care.
This strategy has largely failed to live up to its potential; only about 4 percent Potentially eligible beneficiaries are enrolled in the traditional Medicare program, according to a Mathematica Analysis.
But Thousands of doctors have increased their salaries by participating, and supporting for-profit businesses have emerged to help doctors take advantage of the program. Analysis of federal data by my KFF health news partner Of Holi. hacker shows about him 4,500 physicians received at least $100,000 Salaries for everyone in chronic care management in 2021.
“This program had the potential to make a big impact,” he said kenneth thorpeOne emory university Health policy professor and expert on chronic diseases. “But I knew from the beginning it would never work because it was designed wrong.”
Centers for Medicare and Medicaid Services Spokespeople did not respond to questions about the program’s low participation rates, and it is unclear whether the agency will address the issue.
Under the CCM program, Medicare pays physicians to develop patient care plans, coordinate treatment with specialists, and conduct routine checkups with beneficiaries. doctors get on average $62 per patient at least per month 20 minutes Useful according to companies in business.
Without the program, providers often have little incentive to spend time caring for their patients because they can’t bill Medicare for the work.
According to Thorpe and other experts, several factors limit participation in the program. Chief among them is that both doctors and patients must opt to participate.
Doctors may not have the ability to routinely monitor patients outside of office visits. Some are also concerned about meeting strict Medicare documentation requirements for reimbursement and are reluctant to ask patients to join a program that may require a monthly co-payment if they have a supplemental policy. Not there.
“It’s very time-intensive and not something that physicians are accustomed to doing or don’t have time to do,” Thorpe said.
There’s evidence that widespread use could lead to savings – plus happier patients, funded by a consortium Study by Mathematica in 2017 The CCM program saved Medicare. $888 per patient per year – mostly due to declining hospital care.
Carrie LesterThe 73-year-old looks forward to the phone call every Thursday from her doctor’s medical assistant, who asks how she is and whether she needs a prescription refill. The assistant gives him advice on how to deal with anxiety and other health problems.
Lester credits Chat for keeping her out of the hospital and reducing the need for clinic visits to manage chronic conditions including depression, fibromyalgia and high blood pressure.
“Just knowing someone is going to check on me is very comforting,” said Lester, who lives in Independence, Kan., with her dogs, Sophie and Dolly.
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