Pomerene Chronic Care Management
What Is Chronic Care Management (CCM)?
In January of 2015, Medicare introduced Chronic Care Management (CCM) as a way to help providers improve healthcare outcomes for those with chronic conditions. Pomerene Family Care and Pomerene Internal Medicine now offer CCM at all outpatient locations and are currently waiving any co-pays to encourage participation by patients who most need the service.
For more information, please call 330-674-1584, extension 6224
Who Benefits From CCM?
- Those who feel overwhelmed and struggle to keep up with multiple prescription and healthcare needs
- Isolated and elderly patients with a limited support system
- Patients with psycho-social challenges and low medical literacy
- Those who would benefit from between-appointment medical oversight, education and encouragement
CCM Benefits Patients by Helping Them:
- Reduce unnecessary hospitalizations and readmissions
- Coordinate multiple medical services and specialties
- Become more engaged in their healthcare experience
- Keep follow-up appointments and remain current on preventative services
- Keep track of medications, dosages and refills
- Recognize developing symptoms or changes before they escalate
What Does a CCM Case Manager Do?
- Serves as an extension or resource between the patient and provider
- Provides a systematic assessment of the patient's medical, functional and psycho-social needs
- assists with the scheduling of recommended preventive care services
- Provides medical reconciliation and oversight of patient's self-management of medications
- Supports 24/7 patient access to care and health information
- Provides telephone interaction with patient and healthcare providers to discuss healthcare needs and goals
Who Qualifies for CCM?
- Patients that have been evaluated within the past year
- Patients receiving Medicare/Medicaid benefits and those with private insurances
- Patients that have multiple (two or more) chronic conditions expected to last at least 12 months
- Patients with conditions that place them at significant risk of death, acute exacerbation/decomposition or functional decline