MELVILLE, NY--(Marketwired - Mar 17, 2016) - Millennium Healthcare Inc. (
The Centers for Medicare and Medicaid Services (CMS) started authorizing provider reimbursement for non-face-to-face care given to chronically ill Medicare patients with two or more chronic conditions. The 2015 Medicare Physician Fee Schedule (PFS) will now pay for non-face-to-face services for CCM. For the first time, physicians will be compensated for managing patients' chronic conditions outside of regular office visits. CMS identified chronic conditions as a leading area where improved care could have a large impact on curbing disease, improving health and lowering costs. Non-face-to-face care includes any time providers spend on their patient's care plan outside of a patient visit, such as communicating with other providers on behalf of the patient or managing the patient's care over the phone or via a secure online communication tool. This care also includes time spent by other clinical staff members supervised by the provider, such as physician assistants and clinical nurse specialists.
The CMS Chronic Care Management (CCM) program is an opportunity for both primary care providers and specialists to create new revenue while increasing the amount of preventative care they can provide their chronically ill Medicare patients. This can increase physician practice revenue without the need to see additional patients and without the need to be a certified Patient Centered Medical Home. CMS anticipates that its CCM program will allow providers to invest in prevention care in order to reduce the more costly, complicated conditions later.
An average of approximately 68.6% of the US senior patient Medicare population is already managing 2 plus chronic conditions, including obesity, diabetes, high blood pressure and cardiovascular disease. Under the new CCM program authorized by CMS, physicians can now bill on average $41.44 per 30 day period for 20 minutes of chronic care activity (non-encounter based follow up care) which annually can add up to an average of almost $500 per year per patient, and based on practice size, substantially add to a practice's total annual revenues. Additionally there are exciting new guidelines being established for telehealth medicine, including video and phone conferencing among other provisions that would cover remote chronic care management further expanding eligible patients and services.
U.S. Chronic Care Management Data: |
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Description | Value | |||
Annual number of unique patients (U.S. average per family medicine provider: 32791) | 3,279 | |||
Percent of patients covered by Medicare (U.S. average: 21.85%1) | 21.85 | % | ||
Annual number of unique Medicare patients | 716 | |||
Percent with 2+ chronic conditions (U.S. average: 68.6%2) | 68.6 | % | ||
Annual number of unique CCM patients | 491 | |||
CCM monthly payment (U.S. average: $41.443) | $ | 41.44 | ||
Estimated annual CCM revenue per family medicine physician practice | $ | 244,164.48 | ||
-- 1Per the MGMA Cost Survey for Single Specialty Practices: 2013 Report Based on 2012 Data specific to the specialty of family medicine. Includes Medicare A/B and Medicare Advantage. -- 2CMS.gov - County Level Multiple Chronic Conditions (MCC) Table: 2012 Prevalence, National Average. -- 3Reimbursement amount from the CY 2015 Physician Fee Service Final Rule, October 31, 2014, averaged across 89 localities. |
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About Millennium Healthcare Inc. (www.millenniumhcs.com)
Millennium Healthcare Inc., through its wholly owned operating subsidiaries, provides primary care physician practices, physician groups and healthcare facilities of all sizes with cutting-edge medical devices focused primarily on preventive care through early detection. The Company also provides advanced billing and coding services, and practice development and management services. For more information, please visit www.millenniumhcs.com.
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