Remote Chronic Care Management, Year 1

Consider the Medicare remote Chronic Care Program, also known as 99490 almost one year after its start.   

The release of Medicare’s first numbers about the new Chronic Care Management Program were underwhelming, given the almost unanimous agreement that making it practical for Physicians and their clinical staff to work with patients between visits was widely lauded.

According to recently released reports from CMS, fewer than 100,000 claims have been filed for an eligible population of 35,000,000.  That’s a paltry .25%.  So why the gap?

There is no doubt the interest is high.  A quick look at search terms for key related components shows how quickly interest has grown.  In eighteen months, the number of searches for Chronic Care Management has met the number of searches for Patient Engagement, though this author believes all three of these terms are intrinsically linked.

But some things don’t add up.  In two independent polls of physicians, the percentages of participating physicians don’t align with Medicare’s estimates of participants and claims filed. The private surveys suggest nearly 70% of eligible physicians don’t understand or know about the program, yet at the same time, 17% are already participating and 52% plan on starting next year.  While 300 physicians of 45,000 surveyed may be statistically significant, it doesn’t account for selection bias, meaning that the physicians who knew or have thought about the program are more likely to respond than those that don’t understand it or don’t know about it.  According to Medicare, less than 10% of primary care physicians submitted claims, and many of these were for a handful of patients. They believe their estimate of 100,000 claims may turn out to be high.

Source: Smartlink Mobile, online survey, 300 respondents

In a second survey, recently completed by consultancy PYA, their respondent pool was also around 300 physicians.  While they showed that 26% of physicians had begun the program, only half of them have submitted a claim.

The pioneers have some arrows in their backs to be sure.  Modern Healthcare, in a recent article on the subject, showed what some of the challenges are in getting a program off the ground.  Other surveys show that the number one obstacle is enrollment; getting patients to pay the co-pay for services that they believe they should get or are getting for free.