In the ever-evolving landscape of healthcare, value-based care has taken center stage. As chronic conditions arise worldwide, there is a need for comprehensive strategies for delivering high-quality healthcare. There was already a care model for patients with multiple chronic conditions and chronic care management, but none for those with only one chronic condition.
In 2020, a new care model for patients with one chronic condition was introduced called principal care management. In this article, we will discuss chronic care management, principal care management, and how to choose the best program for yourself.
What is Chronic Care Management?
Chronic care management is a patient care model for managing patients with chronic diseases. It plays a huge part in improving patient care. It goes beyond clinical visits and encompasses patient assessment, support, and constant guidance. The main goal of CCM is to help patients better manage their chronic conditions. These chronic conditions include heart disease, cancer, stroke, diabetes, renal disease, chronic respiratory disorders, septicemia, pneumonia, influenza, Alzheimer’s disease, and post-injury recovery. In a CCM program, a healthcare professional monitors the patient’s condition, coordinates care, and offers guidance.
What is Principal Care Management?
CMS announced a new care model, principal care management, in 2020 to provide additional care to patients diagnosed with one chronic illness. This was introduced to address the gap left by CCM treatment for people with just one chronic illness. One of the primary goals of PCM is to focus on the patient’s chronic illness as soon as possible and provide tailored care to stabilize it so that they can be re-transferred to their primary care providers. This helps reduce the patient’s healthcare expenses and results in better patient outcomes.
How to Choose Between CCM and PCM
While drastically similar, principal and chronic care management are distinct programs for improving patient outcomes. They both have been transformative in improving patient care. So, how can you choose between the two? Let’s discuss further.
Time
When looking at timelines, CCM is usually adaptable for years of implementation and requires a minimum duration of 12 months for chronic conditions. The goal of CCM is to work alongside primary care and it is not a short-lived program.
PCM is a short-term patient care program. It requires a minimum of three months, and its goal is to stabilize the patient so they can be retransferred to the primary care provider. Its maximum expected duration lasts about a year.
Billing
When it comes to billing, CCM requires 20 minutes of billable time, while PCM requires 30. Elements of care management for both programs can include a systematic needs assessment (medical and psychosocial), the encouragement of preventative services, medication reconciliation, management, and promotion of patient self-management.
Care Plan
There is a difference in how the care plans are managed. A CCM care plan does not need to be updated frequently and allows for more time for care. CCM plans can be implemented with less specificity and focus on overall well-being.
PCM demands continuous revision of a care plan as well as input from qualified physicians. PCM care plans must be disease-specific and outline concrete strategies to address the specific condition.
Patient Needs
Before choosing a program, it is important to assess the needs of your patients. CCM can be used as a generalized strategy as it demands that the patient have at least two chronic diseases.
PCM is intended for people who have a single high-risk or complex chronic condition. This allows for more individualized care. Thus, PCM can be the best option if you have a range of patients that require specialized care. If the patients in your practice would benefit from both CCM and PCM, a hybrid model is the best way to go.
Conclusion
Both principal care management (PCM) and chronic care management (CCM) are transformational in improving patient care. The choice depends upon what aligns best with your unique circumstances. As healthcare continues to evolve, patient experience keeps improving, and so does technology.
CareCloud is introducing a robust principal care management solution to enhance the workflow of your practice and increase revenue.
