Chronic Care Management

Living an active and fulfilling life

Managing your health can be overwhelming, but it doesn’t have to be. Chronic Care Management (CCM) can assist you in living a healthier life and being present with the ones you love Chronic care management (CCM) is a Medicare Part B benefit delivered by your Primary Care Physician’s team for individuals with two or more chronic conditions.

At Prime Medical, we always believed in “Individualized Care, Centered on You”, the CCM benefit allows your doctors to offer services outside of doctor’s office visits to help Medicare beneficiaries with multiple chronic conditions follow their medical care plan, practice preventive health care, and more effectively manage their chronic conditions and overall health.

Assistance in accessing needed resources to optimize self-care is a primary goal of CCM services.  What types of conditions qualify for CCM?

  • Alzheimer’s Disease
  • Arthritis
  • Asthma
  • Atrial fibrillation
  • Autism spectrum disorders
  • Cancer
  • Cardiovascular Disease
  • COPD
  • Depression
  • Diabetes
  • Hypertension or High Blood Pressure

What types of services can be provided under CCM?

There are a wide range of services that can be provided under CCM for Medicare beneficiaries with multiple chronic conditions. While the list below is not exhaustive, it provides examples of the types of services that can be provided:

  • Care management and transitional care management services
  • Communicating with the Medicare beneficiary in person, by phone, or electronically for care coordination
  • Community resource referral and linkage
  • Coordinating community and social support services
  • Disease self-management education and support
  • Health coaching
  • Health education, including health literacy
  • Interventions to reduce falls or risk factors for falls
  • Medication management
  • Preventive health counseling
  • Symptom management

What are the benefits of CCM?

  • Regular CCM means you can better manage your care and spend more time focusing on your health. CCM can help you work toward your health and quality of life goals. Better care management can help you avoid health events such as trips to the emergency department, a fall, or worsening health.
  • Coordinated care means you will get personal attention and help from a health care provider you know and who knows about your health conditions and helps to keep you healthy.
  • Your dedicated care team will review your records and may contact you if needed. They may also connect with you about how they are working for you and your health.
  • CCM services will help us work more closely with your other doctors, and help you maintain your health and wellness.

If you don’t think you need CCM, you can ask us to stop at any time. Please note: The usual cost-sharing rules apply to these services, so many patients are responsible for the usual Medicare Part B cost sharing (deductible and copayment/coinsurance) if they do not have supplemental (“wrap-around”) insurance.

Please note that the majority of dual eligible beneficiaries (patients with Medicare-Medicaid) are not responsible for cost-sharing. Medigap plans also provide wrap-around coverage of cost sharing for CCM, with many beneficiaries have Medigap or other supplemental insurance.