Use of chronic care management service among Medicare beneficiaries in 2015–2019

Author:

Jang Jieun12,McCarthy Ellen P.13ORCID,Olivieri‐Mui Brianne14ORCID,Shi Sandra M.1ORCID,Park Chan Mi1ORCID,Oh Gahee1,Sison Stephanie Denise M.15ORCID,Kim Dae Hyun13ORCID

Affiliation:

1. Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife Boston Massachusetts USA

2. Department of Hospital Administration Yonsei University Graduate School of Public Health Seoul Republic of Korea

3. Division of Gerontology, Department of Medicine Beth Israel Deaconess Medical Center Boston Massachusetts USA

4. Department of Health Sciences Bouvé College of Health Sciences, Northeastern University Boston Massachusetts USA

5. Division of General Internal Medicine University of Massachusetts Chan Medical School Worcester Massachusetts USA

Abstract

AbstractBackgroundThe Centers for Medicare and Medicaid Services (CMS) introduced chronic care management (CCM) services in 2015 for patients with multiple chronic diseases. Few studies examine the utilization of CCM services by geographic region, sociodemographic, and clinical characteristics.MethodsWe used 2014–2019 Medicare claims data from a 5% random sample of fee‐for‐service beneficiaries aged 65 years or over. We included beneficiaries potentially eligible for CCM services because they had multiple chronic conditions (1,073,729 in 2015 and 1,130,523 in 2019). We calculated the proportion of potentially eligible beneficiaries receiving CCM service each year for the total population and by geographic region, sociodemographic, and clinical characteristics.ResultsThe proportion of beneficiaries with two or more chronic conditions receiving CCM services increased from 1.1% in 2015 to 3.4% in 2019. The increase in CCM use was higher in the southern region, among dually eligible beneficiaries and beneficiaries with a greater burden of chronic conditions (2–5 conditions vs ≥10 conditions: 0.7% vs 2.0% in 2015; 2.1% vs 7.0% in 2019) and frailty (robust vs severely frail: 0.6% vs 3.3% in 2015; 1.9% vs 9.4% in 2019). Nearly one out of five recipients did not continue CCM service after the initial service.ConclusionWe found that CCM service is being used by a very small fraction of eligible patients. Barriers and facilitators to more effective CCM adoption should be identified and incorporated into strategies that encourage more widespread use of this Medicare benefit.

Funder

National Institute on Aging

Korea Health Industry Development Institute

Publisher

Wiley

Reference26 articles.

1. The Facts about Medicare Spending.Kaiser Family Foundation. Accessed August 17 2023.https://www.kff.org/interactive/the-facts-about-medicare-spending/

2. Health and Economic Benefits of Chronic Disease Interventions.Centers for Disease Control and Prevention. Accessed August 17 2023.https://www.cdc.gov/chronicdisease/programs-impact/pop/index.htm

3. Providing Primary Care in the United States: The Work No One Sees

4. Chronic care management services.Centers for Medicare and Medicaid Services.2022. Accessed August 17 2023https://www.cms.gov/outreach‐and‐education/medicare‐learning‐network‐mln/mlnproducts/downloads/chroniccaremanagement.pdf

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