Chronic Care Management Trends: Half of Healthcare Organizations Poorly Positioned for Care Coordination Revenue

Nearly half of healthcare organizations have yet to launch a chronic care management program, leaving critical Medicare reimbursement dollars on the table, according to new market metrics from the Healthcare Intelligence Network.

Sea Girt, NJ, February 17, 2015 --( Almost one in two respondents lack the comprehensive chronic care management (CCM) approach necessary to profit from Medicare's new reimbursement structure for select CCM services, according to benchmarks compiled by the Healthcare Intelligence Network (HIN), a leading publisher of healthcare news, metrics and trends.

Effective January 1, 2015, new CMS codes for chronic care management opened the door to improved patient outcomes as well as care coordination revenue for physician practices.

Nearly all respondents—92 percent—believe Medicare's actions will prompt equivalent quality overtures from private payors, underscoring the importance of care coordination in value-based healthcare.

More results from this survey are available in the latest HINtelligence report, "Chronic Care Management in 2015," a complimentary downloadable white paper.

Download this white paper on "Chronic Care Management in 2015" at

News Facts: HIN's white paper, Chronic Care Management in 2015, summarizes January 2015 responses from 119 hospitals/health systems, health plans, physician practices, disease management and health coaching organizations and others on approaches to coordinating care for patients with chronic illness.

Other data highlights from the survey include the following:

-A diagnosis of diabetes is the leading criterion for admission to a chronic care management initiative, said 89 percent of respondents.

-Follow-up with patients immediately following hospital discharge is the most common component of CCM initiatives, said 81 percent of respondents.

-Just over one-third of respondents—35 percent—are currently reimbursed for activities related to CCM.

-On average, each CCM patient is seen monthly, say 29 percent of respondents.

In open-ended responses, organizations noted that patient registries, population health management software and telephonic case management are effective means of supplementing a chronic care management effort.

Download this white paper on "Chronic Care Management in 2015" at

Quote Attributable to Melanie Matthews, HIN Executive VP and COO:

"While there are still areas where CMS must provide clarification on chronic care management codes, healthcare organizations should not miss this opportunity to improve patients' health outcomes and generate additional revenue. Many private payors are already constructing quality-based reimbursement models to reward providers on effective management of chronic illness on the heels of this CMS decision."

To view Melanie Matthews's profile, please visit
Please contact Patricia Donovan to arrange an interview or to obtain additional quotes.

About the Healthcare Intelligence Network — HIN is the premier advisory service for executives seeking high-quality strategic information on the business of healthcare. For more information, contact the Healthcare Intelligence Network, PO Box 1442, Wall Township, NJ 07719-1442, (888) 446-3530, fax (732) 449-4463, e-mail, or visit
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Patricia Donovan