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Chronic Care Management FAQs

Chronic Care Management FAQs

What is Chronic Disease? 

Chronic Disease is a long-lasting condition that can be controlled but not cured.  Chronic illness affects the population worldwide. As described by the Centers for Disease Control, chronic disease is the leading cause of death and disability in the United States. It accounts for 70% of all deaths in the U.S., which is 1.7 million each year. Data from the World Health Organization show that chronic disease is also the major cause  of premature death around the world even in places where infectious disease are rampant. Although chronic diseases are among the most common and costly health problems, they are also among the most preventable and most can be effectively controlled.

What conditions are considered chronic?

A patient must have two or more chronic conditions that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline. Such conditions are, but not limited to: Alzheimer’s disease and related dementia, asthma, cancer, depression, diabetes, ischemic heart disease, and osteoporosis.

What are the chronic care benefits?

  • Reduction in inpatient admits and readmissions
  • Reduction in medical expenses
  • Reductions in ER visits
  • Medication management/coordination
  • Continuity of care coordination
  • Improved health and quality of life

What is the Eligibility? 

If you have Medicare, you must meet all of these conditions to be covered for chronic care management service.

  • You must be under the care of a doctor
  • You must be getting services under a plan of care established and reviewed regularly by a doctor
  • You must be certified by a doctor that you need home healthcare
  • You must have multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decompensation, or functional decline

Please contact us with any questions about your specific case so that we can determine your eligibility for home healthcare.