Aprima Medical Software has announced the availability of new Chronic Care Management (CCM) functionality for the Aprima EHR system, which can help physicians more easily document, bill, and be reimbursed for chronic care management services.
According to the company, patients with chronic illness experience better outcomes and lower cost of care when providers are involved in their care management. However, until 2015 CMS did not reimburse physicians for such services. Today eligible Medicare providers that track their activities can be compensated for services such as the regular development and revision of a patient plan of care, communication with other treating professionals and medication management.
“The CCM program provides a great opportunity to improve the care of patients with chronic conditions, as well as compensate physicians for services that they’ve long provided for free,” stated Michael Nissenbaum, president and CEO of Aprima. “Unfortunately many physicians have opted not to take advantage of the program because they’re unable to track these activities automatically. However, our new CCM functionality automates the process through Aprima EMR, which ultimately benefits physicians and their patients with chronic illness.”
To qualify for monthly reimbursement of approximately $42 per month per beneficiary, clinical staff must document their activities, including the minutes spent providing care, plus bill and collect Medicare fees and patient co-pays. With Aprima’s CCM program, all these functions are automated.
“More than 21 million Medicare patients have two or more chronic conditions,” said Jeffrey Hyman, MD, CMO of University Physicians Group in Brooklyn. “These patients visit their doctors more frequently and are in need of efficient, evidence-based medical care to improve their overall health, and in doing so, reduce the cost of their care. Doctors have not adopted Medicare’s new reimbursement program for Chronic Care Management during its first year for many reasons, but now Aprima’s technology has made it easy for providers to identify and track eligible patients, as well as bill and collect for chronic care management services.”
According to the Center for Disease Control (CDC), about half of all adults have one or more chronic health conditions and one in four have two or more chronic health conditions. In 2010, 86% of all healthcare spending was for the 50% of the population with one or more chronic medical conditions. CMS established the chronic care management CPT code 99490 in hopes of improving the health of this large segment of the population and controlling their care costs, while also helping to cover providers’ care management costs.
To qualify for Medicare reimbursement providers must care – and track – at least 20 minutes of clinical staff time per calendar month. Despite the promise of additional revenue, many providers have opted not to participate in the program due to the onerous tracking requirements.
“With Aprima’s CCM functionality I can ensure that chronically ill patients get the follow-up care they need between the times that they see me in the office,” added Hyman. “Aprima’s process assists the patients to be healthier and thereby reduce their use of other more expensive medical resources. It’s efficient for all busy clinicians treating chronically ill patients.”