Chronic Care Management provides primary care that contributes to better health and care for patients with multiple chronic conditions; these conditions include Alzheimer’s and related dementia, arthritis, atrial fibrillation, autism spectrum disorders, cancer, cardiovascular disease, chronic obstructive pulmonary disease, depression, diabetes, hypertension, infectious diseases such as HIV/AIDS, and other chronic conditions. Patients have access to the providers 24 hours a day, 7 days a week, and this service includes face-to-face visits as well as communication by phone, televisit (video call), and email.

A comprehensive care plan is developed, which includes your health issues,  goals, providers, medications, and other services you have or may need. It also explains the care you need and how your care will be coordinated. Your health care provider will ask you to sign an agreement to provide this service. Transitional care management will also be provided in the event of an emergency room visit, hospitalization, or other facility discharge. Your health care provider will ask you to sign an agreement to provide this service.

Chronic Care Management may help a patient have reduced pain, increased mobility, and better sleep. Ideally, patients receiving chronic care management will be able to return to some of the activities that they used to do before and achieve a better quality of life with the help of continuous management of their chronic conditions.

Resources for You
Watch this animated video in English or Spanish to learn about the benefits of CCM services.

Want to learn more? Click here for more details on Chronic Care Management from Medicare.