Abstract
Chronic diseases are the leading cause of death and disability in the United States each year. According to the Group Health Research Institute (2015), almost one-half of all Americans have one or more chronic health diseases. Two of the most common of these are type 2 diabetes mellitus and hypertension. Inadequate management of chronic diseases lead to poor patient outcomes and higher health care costs. In an effort to transform the current health care system, the Centers for Medicare and Medicaid (CMS) introduced a non-visit based payment reimbursement program for chronic care management services. Providers caring for Medicare beneficiaries with two or more chronic diseases that are expected to last at least 12 months can receive a monthly fee of $42 per beneficiary who participate in a chronic care management program, utilizing CPT code number 99490 (U.S. Department of Health and Human Services, 2015). The purpose of this practice change project was to create a pilot quality improvement program for the implementation of chronic care management services within an affordable care organization. Using a retrospective chart review, 100 charts from a rural primary care clinic were examined for improvement of blood pressure readings and HgB A1C levels of patients enrolled in this program. Medicare reimbursement for the patients enrolled in the chronic care management program was also examined for improvement.
Sigma Membership
Non-member
Type
DNP Capstone Project
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
Pilot/Exploratory Study
Keywords:
Chronic Care, Care Management, Affordable Care
Advisor
Lorraine Gaddis
Second Advisor
Shonda Phelon
Third Advisor
Alena Lester
Degree
DNP
Degree Grantor
Mississippi University for Women
Degree Year
2017
Recommended Citation
Duke, Lori, "Quality improvement program: Implementation of chronic care management services in an affordable care organization" (2017). DNP and Student Works. 126.
https://www.sigmarepository.org/dnps/126
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Rights Holder
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Review Type
Faculty Approved: Degree-based Submission
Acquisition
Self-submission
Date of Issue
2017-06-23
Full Text of Presentation
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