Medicare Chronic Care Management (CCM) Program

If you are a Medicare member with two or more chronic health conditions, you qualify for our Chronic Care Management (CCM) program. Qualifying conditions include:

Alzheimer’s Disease High Cholesterol (Hyperlipidemia)
Atrial Fibrillation (A-Fib) Depression
Breast Cancer Diabetes
Congestive Heart Failure (CHF) Dialysis
Coronary Artery Disease (CAD) High Blood Pressure (Hypertension)
Chronic Obstructive Pulmonary Disease (COPD) Hypothyroidism

 

In addition to your regular physician/nurse care team, the Chronic Care Management team consists of Registered Nurses (RN’s) and Licensed Practical Nurses (LPN’s) specially trained in chronic care management who serve as a link between you and your provider. You will receive routine phone calls to discuss your plan of care plus education related to your disease state and medications.  In addition, you will be taught how to spot signs and symptoms that need attention while learning what plan of action to take if it occurs.

You also may call your Chronic Care Nurse for additional education, questions about your treatment plan, or concerns about signs and symptoms. If a problem is identified needing immediate attention, the nurse may schedule an appointment for you to see your provider.

If you are interested in the Chronic Care Management program, please talk to your provider at your next office visit.