Chronic Care Management

TUCWC offers straightforward Chronic Care Management platform that may be easily integrated into the operations of healthcare facilities. With the help of our CCM services, we give users the ability to think of our care management team as an addition to their personnel, ensuring that they receive the effective and efficient care coordination they require.

Given its weight in value-based reimbursement, Chronic Care Management quality should be clinicians’ primary and most immediate focus. Offering chronic care management services is the key to improving quality of care, since two-thirds of Medicare beneficiaries have two or more chronic conditions.

Furthermore, CCM participation hits thirty three measures in the MIPS “Quality Category” and includes twenty two high priority measures. It also fulfills some CPI activities, addresses cost/resource use by decreasing avoidable interventions, and encourages use of EHRs.

— Coordinate care among all physicians, care givers, & services
— Promotes adherence to directives & medication orders
— Health promotion and disease prevention

— 38% Decrease in hospital admissions/readmissions
— 30% Decrease in non-critical ER visits

Now that healthcare has shifted to value-based reimbursement, the importance of care coordination has been elevated. Even a perfect business model, operational model, or clinical model cannot compensate for uninvested patients who don’t control their clinical conditions. This means new skills are needed for care managers to produce improved results.

Using Healthcare Coaching and Motivational Interviewing techniques, our chronic care management and coordination is conducted with the ultimate view of first; making sure the patients understand the provider’s directives, then we help the patient set plans and goals to ensure adherence to those directives.