Talking to Your Patients About Chronic Care Management (CCM)

Tips on How to Explain CCM to Your Patients

Chronic care management (CCM) is an effective tool that empowers patients to better understand and manage their chronic conditions. However, for it to be effective, patients must understand its benefits and how it can improve their overall health and quality of life. The information below is designed to help healthcare professionals talk to patients and caregivers about the advantages of CCM services.

Question: What is CCM?

Answer: If you have two or more chronic conditions, CCM services can help you better manage your health. CCM provides extra support between your regular doctor’s visits to help you reach your health goals.

For example, you’ll receive help from a healthcare professional who checks in with you every month, offers 24/7 emergency access, helps coordinate care with your pharmacy, specialists, and hospitals, and ensures you get the care you need.

Question: Who is eligible for CCM?

Answer: If you have two or more chronic conditions, you may be eligible for CCM services. Some examples of chronic conditions include, but are not limited to:

• Alzheimer’s disease and related dementia
• Arthritis (osteoarthritis and rheumatoid)
• Asthma
• Atrial fibrillation
• Autism spectrum disorders
• Cancer
• Cardiovascular disease
• Chronic obstructive pulmonary disease (COPD)
• Depression
• Diabetes
• Hypertension
• Infectious diseases such as HIV/AIDS
• Substance use disorders

Question: What do CCM services include?

Answer: If you’re eligible for CCM, you’ll get extra support to help you manage your health. This includes:

• A healthcare professional who will work with you to create a care plan just for you
• Coordination of your care between your pharmacy, specialists, hospitals, and more
• Regular phone check-ins to make sure you’re staying on track
• Help with understanding your health and setting goals
• 24/7 emergency access to a healthcare professional

Question: What are the benefits of CCM?

Answer: Chronic Care Management is here to help you stay healthier and manage your long-term conditions better. With CCM, you’ll have more support from a care team and get help sooner to prevent problems before they get worse. This extra care can help you avoid things like emergency room visits, falls, or your health getting worse, so you can work towards feeling your best.

Question: Who pays for CCM?

Answer: Medicare and most other insurance plans cover the cost of CCM. Standard copays and deductibles will vary.

Question: What is Informed Consent?

Answer: To receive CCM services, patients must provide consent. This can be done either in writing or verbally, and it will be noted in the medical record. Here’s some examples of what we might ask during that conversation:

• Your care team will review your records and may reach out to help manage your care.
• Do you have any questions about the CCM services?
• Do you agree to receive these services?
• Do you understand that there may be a monthly fee for CCM services?
• How would you like us to contact you, and when is the best time for us to reach you?