KNOWING you’re extending care to improve quality

Capacity-constrained practices need a better solution for chronic care management

Multiple chronic conditions are responsible for 75% of typical primary care visits1 and 70% of all inpatient stays.2 As a result, capacity-constrained primary care physicians must act as the care coordinator for multiple providers.

Patients with multiple chronic conditions need care coordination between office visits—to ensure they’re keeping their appointments and to make appointments more productive, to help improve compliance and self-care support, and to track progress.

Quest Diagnostics is now offering a solution that can help both your practices and your patients.

Meet the challenge of monthly care coordination under Medicare

Extend care delivery to Medicare patients with multiple chronic conditions with Quest Chronic Care Management (CCM) Services. This program is designed to help you improve patient outcomes and quality metrics, reduce costly ER visits and hospital readmissions, and help inform and support population health management initiatives.

With Quest CCM Services, your health system or accountable care organization benefits from:

Find out if your practices are eligible for CCM Services by reviewing our participation requirements and expectations.

A comprehensive program for improved quality

Quest CCM Services can help align physicians to your care goals and assist them in closing gaps in care, and improving quality ratings and patient risk management. The CCM Services platform:

  • Offers easy-to-use technology that integrates with your physicians’ existing clinical workflows
  • Can connect to your EHR, allowing both clinicians and members of Quest’s CCM care team to review necessary patient information

Tools to help improve practice economics

Quest CCM Services can help you control costs by potentially reducing unnecessary office visits, ER visits, and hospital readmissions. Our services also help clinicians comply with the Centers for Medicare & Medicaid Services (CMS) reimbursement requirements for 20 minutes of non-face-to-face chronic care management per patient per month (CPT code 99490; CPT code 99487 for 60 minutes of complex care*), while minimizing disruptions and saving staff time.

  • Every encounter is properly tracked
  • Practices receive a monthly report that documents the provision of 20 minutes of non-face-to-face patient management per patient

Expertise to extend care and close gaps

Medicare patients with multiple chronic conditions will be assigned dedicated nurse care coordinators. Our care coordinators have years of experience supporting patients with multiple chronic conditions, and they have a keen understanding of patient needs. Some of the services provided include:

  • Monthly phone calls with patients to check in
  • Development of comprehensive care plans that will be approved by a practice physician(s)
  • Medication reconciliation to help guard against error and ensure patient safety
  • Physician notification if patient reports an ER visit, hospital discharge, or skilled nursing facility stay
  • Coordination with specialists and home- and community-based service providers

Quest CCM participation requirements and expectations

The qualified practitioners billing for CCM Services must:

•   Record patient information in certified EHR technology

•   Offer 24/7 urgent care support or on-call services, with access to the patient's records

•   Stay engaged by overseeing the creation of and updates to care plans

•   Be willing to work with care coordinators to ensure the care plan is clinically
    integrated or aligned with the overall treatment plan for the patient

Extend care–and close gaps

Contact us for more information
 
Download the CCM Services health system/ACO brochure

 

  1. Zamosky L. Chronic disease: A growing challenge for PCPs. Medical Economics. 9 Aug 2013. Available at medicaleconomics.modernmedicine.com/medical-economics/content/tags/ chronic-disease/chronic-disease-growing-challenge-pcps. Accessed July 7, 2017.
  2. Gerteis J, Izrael D, Deitz D, et al. Multiple chronic conditions chartbook. AHRQ Publications No. Q14-0038. Rockville, MD: Agency for Healthcare Research and Quality; 2014.
  3. Centers for Medicare and Medicaid Services. Chronic conditions among Medicare beneficiaries, Chartbook, 2012 Edition. Baltimore, MD. 2012.

* The CPT codes provided are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payer being billed.
† Refer to CMS 2017 Medicare Physician Fee Schedule Final Rule for direction on billing CCM CPT codes 99490 and 99487.