If a chronically ill Medicare patient stops taking his medication, Dr. Jim King finds out about it within a week.
That's because one of his staff calls to find out, learns why and then follows up to remedy the issue.
This way of working has improved the health of his patients and saved—even earned—his practice money.
Since January, the CMS has covered monthly expenses for chronic-care management of patients not conducted during a face-to-face patient visit.
The CMS reported that about 35 million Medicare beneficiaries are eligible to receive these billable care-management services. But the agency has received reimbursement requests for only about 100,000.
Complaints about the chronic-care management reimbursement program vary from lengthy documentation to having to have a difficult conversation with patients who now are responsible for a 20% copayment for previously free services.
Primary-care advocates hoped the care-management fee would transform some practices, encouraging them to invest in infrastructure and adopt a team-based model of care.
And that's happening for some, like Dr. King.