Care Coordination Reimbursed CMS

Medicare will pay doctors to coordinate care for chronic conditions

Care Coordination Reimbursed CMSA reimbursement change is in line for physicians to coordinate the care of patients with chronic disease.  Details below.

CMS next year plans to start paying physicians a monthly fee to coordinate the care of beneficiaries with chronic diseases as part of a broader effort to improve continuity of care, the New York Times reports.

For each beneficiary with two or more chronic conditions—such as heart disease, diabetes, or depression—who signs up, physicians will receive $42 per month.

For each beneficiary with two or more chronic conditions—such as heart disease, diabetes, or depression—who signs up, physicians will receive $42 per month.

Physicians who receive the fee must develop a comprehensive plan for each participating patient’s care. Physicians also must:

  • Assess patients’ medical, psychological and social needs;
  • Ensure patients take their medications;
  • Monitor care given by other doctors; and
  • Arrange for smooth transitions when patients move between different care facilities.

In addition, CMS will require the physicians to start using electronic health records to better exchange information with all care providers involved with a patient.

Participating patients must have access to doctors and other health professionals 24 hours a day, seven days a week to help tend to “urgent chronic care needs.” Care management services can be provided by nurse practitioners, physician assistants, and other qualified health care providers.

Previously, physicians provided such services but had not been paid to provide similar care management services. The initiative is being implemented amid growing evidence that poor coordination can cause medical errors and disjointed care (Pear, New York Times, 8/16).

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