Linda King is a "client success specialist" at DocsInk, a medical services company in Wrightsville Beach, N.C., who has previously talked with Part B News on the subject of chronic care management. We shared with her new CMS data from 2016 showing a jump from 1.1 million CCM claims in 2015 to 2.5 million in 2016. Here are her thoughts:
I am not surprised by the uptick in number of CCM claims submitted from 2015-2016, although I expect CMS data will reveal a larger increase from 2016 to 2017. The 2.5 million CCM claims that CMS reported receiving in 2016 is still a relatively low number, considering an estimated 35 million Medicare beneficiaries are treated for multiple chronic conditions.
In talking with providers and consultants around the country, the general consensus was that CMS' initial guidelines were very stringent, and difficult to implement. As you know, in an effort to encourage clinicians to offer CCM services, CMS recently made
significant changes to ease billing rules and expand coverage. We believe these changes, along with the alignment between CCM and MIPS quality reporting, will prove to have a positive impact on the number of CCM claims submitted in 2017.
[DocsInk] has not had any providers inquire into tracking the BHI services/time -- yet. This is something we will continue to look into. Off the cuff, I can see that some Medicare patients will fall into both clinical services categories, and could certainly benefit from each. It is of note that one of the largest barriers to adoption reported has been the related cost-sharing for beneficiaries that are not dually eligible or do not have a supplemental policy that covers those expenses...We have heard from many clinicians that it has been difficult to get patients to enroll in CCM when they expected to have an out-of-pocket expense.