With the start of 2012, about 50% of all adults —117 million individuals—had chronic health conditions. One out of every four had at least two chronic health conditions.
Keeping up a solid income while adapting to an always changing healthcare policies is overwhelming. You have to get ready today for the inescapable parade of evolving regulations, redesigns to payer rules and developing methodologies.
In 2017 The Centers for Medicare & Medicaid Services (CMS), acknowledged that there are both non-complex and complex Chronic Care Management services provided to patients. Thus, CMS added two new codes for what they now call Complex CCM Services. Moreover, they included new CPT codes for the initiating visit.
This evolution toward value-based service benefits the patient, the healthcare provider and the payer. Value-based models encourage healthcare providers to deliver the best care at the lowest cost. In turn, patients receive a higher quality of care at a better value.
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) replaces the Medicare Sustainable Growth Rate (SGR), which was how CMS previously controlled the cost of Medicare payments to physicians. MACRA is aimed at strengthening Medicare access and improving physician payments, among other improvements.