Willamette Heart and Family Wellness
Across the country, in an area where pioneers once traveled the Oregon Trail, Willamette Heart and Family Wellness, a family medicine practice in McMinnville, Ore. with a single physician, two nurse practitioners and one physician assistant, is acting as a forerunner of its own. Like Family Medical, it too is using CPT code 99490 to manage care for its primary-care and cardiac patients and is moving in the direction of value-based care.
"Chronic care management is [valued-based care] that you can profit off immediately and add to your bottom line without adding to your workload," says Sarah Hurty, practice manager at Willamette Heart and Family Wellness. "It doesn't matter what cool thing you add on right now that Medicare pays for, that adds to patient value, to preventive care, to a wellness approach … if you don't have chronic care management in place, you are going to get penalized up to 9 percent. It makes no sense to add the icing to the cake if you don't have the cake. Chronic care management is the cake."
The top challenge with the practice's effort in CCM, according to Hurty, is getting 100 percent doctor buy-in, in order to change their processes and transform the practice. Another one is getting patients on board, especially with the copay required of them. "If it costs the patients anything, you have a little bit of a barrier right there," Hurty says. "They are getting charged for something they can't see or they think you are doing already."
Regardless of these challenges, conducting CCM correctly will decrease hospitalizations, add value to patient care, and move practices into the direction Medicare is going, says Hurty. "It's low-hanging fruit," she says, adding it will help providers buy time until the real challenges with value-based care begin.