Real talk about running a real Chronic Care Management (CCM) program
Written by Kim Giroski, Implementation Specialist
Congratulations! You’ve made the smart decision to outsource your Chronic Care Management (CCM) program. You signed the contract, followed the process, and enrolled patients. But why doesn’t it feel successful? Sure, you’re seeing reimbursements start to flow, but it doesn’t seem to be as much as you thought, and why do you keep hearing from your staff, “CCM is a lot of work”?
There are numerous, real-world examples of practices that chose for the right reasons to work with a CCM partner but ended in failure because they did not follow recommended strategies for success. At ChartSpan, this is what we call, “Failure to Launch”. When a CCM program does not meet its potential for profitability and improved patient outcomes, it is considered a failed program. Let’s explore the reasons why this happens.
#1 Not knowing or sharing the “Why”
Knowing why you started a CCM program and explaining that reasoning to your team is critical in the success of your program. For most organizations, there are three different reasons to start a CCM program.
- A successful CCM program drives a significant, monthly stream of revenue. In addition, patients enrolled in a CCM program frequently return to the practice for appropriate follow-up appointments, creating additional revenue.
- Quality Measures
- CCM helps ensure patient compliance with important quality measures and improve MIPS, ACO and Quality Improvement performance.
- Patient Outcomes
- Patients enrolled in Chronic Care Management programs have fewer hospitalizations and ED visits than those that are not. In addition, CCM has proven to reduce patients’ annual out-of-pocket medical costs.
Think about your primary reason for starting a CCM program. Once you have defined your “why” it’s critical to clearly communicate and reinforce this with your providers, patients and staff so they understand and find value in the program.
#2 Resistance to change
When starting a CCM program, there are changes for everyone, including patients, providers, and staff. Providers and staff may have misconceptions that CCM will add more work, and patients may have concerns about the legitimacy of the program. So, how can you help manage the change process and defuse potential negativity?
- Patients: Start marketing your CCM program as soon as possible! The earlier patients hear about your program, the more comfortable they become with it. In the clinic, hang up posters and hand out brochures to patients. Update your website with information on “What is CCM”, and “How to Enroll”. Use social media to promote your CCM program and even create posts with patient success stories!
- Providers & Staff: Socialize your CCM program with your team using different channels to make sure you are heard. Send out an email, keep resources in the break room, and speak about CCM during every practice meeting and share the outcomes data regularly.
- Encourage participation to drive excitement
- Patients: Encouragement from the practice for patients to enroll in CCM is a key to success. You know your patients better than anyone, and you know why they should enroll in a CCM program. Consistent encouragement from the practice drives participation and longevity of a patient being in CCM.
- Providers & Staff: Even with an outsourced CCM program, participation from your team is important. Whether it’s the providers answering patient questions, the nurses communicating with care coordinators, or the billing team sending claims each month, each one plays an important role for the success of your CCM program. Make sure providers and staff understand the impact of their role with CCM. You can do this by requiring participation in training, regularly updating your staff on progress, and sharing patient success stories.
- Be transparent
- Patients: Being a part of a CCM program has many benefits, but for some patients the program comes at a cost. Being transparent with patients about potential copays and deductibles is critical for the longevity of your program.
- Providers & Staff: Even with frequent communication and encouragement, your team will still have questions or concerns. Embrace this! Share CCM data and patient success stories, and have your team join meetings with your CCM vendor.
# 3 No growth plan
Someone once said, “A goal without a plan is just a wish”. This is especially true with your CCM program, without a true growth plan your program has the potential to stall or fail. One of the benefits of outsourcing CCM with ChartSpan is that you will have a resource to help you manage your success. Let us grow together! You will be assigned a dedicated Client Success Manager who will guide you through setting short and long term metrics for your program based on your “why”. They have access to data to help you develop the best plan for achieving your maximum potential. Managing a CCM program requires consistent focus on patient churn and patient satisfaction. Your Client Success Manager will provide you with monthly, quarterly, and annual business reviews to evaluate these metrics and your growth and profitability.
So what have you learned? Ultimately, it is extremely important to follow the recommended strategies when preparing for and starting your program. Without communication, a plan, and a “why”, you’re more likely to fail. Leverage the resources your partner should bring to the table and approach your Chronic Care Management program with these tips in mind – you’ll be sure to have a successful CCM program.
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