Non-Face-to-Face Chronic Care Management: A Qualitative Study Assessing the Implementation of a New CMS Reimbursement Strategy

Valerie Yeager, Mary Kristina Wharton, Alisha Monnette, Eboni G. Price-Haywood, Elizabeth Nauman, Rebekah S.M. Angove, Lizheng Shi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Diabetes and its comorbidities are leading causes of morbidity and mortality in the United States and disproportionately in Louisiana. Chronic care management (CCM) efforts, such as care coordination models, are important initiatives in mitigating the impact of diabetes, such as poorer health outcomes and increased costs. This study examined one such effort, the Centers for Medicare & Medicaid Services' non-face-to-face CCM reimbursement program, for patients with diabetes and at least 1 other chronic condition in Louisiana. This qualitative study included interviews with patients in this program and health care providers and system leaders implementing the program. Results include lessons learned from health system leadership relating to CCM design and implementation, challenges experienced, overlapping initiatives, perceived benefits, performance, billing, and health information technology. Another key finding is that co-pays seem to be a barrier to patient interest in participation in non-face-to-face CCM, especially given that the value of the program is not completely clear to patients. A common strategy to address this co-pay barrier is to target dual eligibles, as Medicaid will cover the co-pay. However, widespread use of such strategies may indirectly exclude individuals who need and may also benefit from non-face-to-face CCM.

Original languageEnglish (US)
Pages (from-to)454-461
Number of pages8
JournalPopulation Health Management
Volume21
Issue number6
DOIs
StatePublished - Dec 1 2018

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Medicaid
Medical Informatics
Health
Medicare
Health Personnel
Comorbidity
Interviews
Morbidity
Delivery of Health Care
Costs and Cost Analysis
Mortality

Keywords

  • care coordination
  • chronic care management
  • diabetes
  • patient-centered

ASJC Scopus subject areas

  • Leadership and Management
  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Non-Face-to-Face Chronic Care Management : A Qualitative Study Assessing the Implementation of a New CMS Reimbursement Strategy. / Yeager, Valerie; Wharton, Mary Kristina; Monnette, Alisha; Price-Haywood, Eboni G.; Nauman, Elizabeth; Angove, Rebekah S.M.; Shi, Lizheng.

In: Population Health Management, Vol. 21, No. 6, 01.12.2018, p. 454-461.

Research output: Contribution to journalArticle

Yeager, Valerie ; Wharton, Mary Kristina ; Monnette, Alisha ; Price-Haywood, Eboni G. ; Nauman, Elizabeth ; Angove, Rebekah S.M. ; Shi, Lizheng. / Non-Face-to-Face Chronic Care Management : A Qualitative Study Assessing the Implementation of a New CMS Reimbursement Strategy. In: Population Health Management. 2018 ; Vol. 21, No. 6. pp. 454-461.
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