Chronic care management: Is the $50 billion market more hype than reality?

Chronic care management: Is the $50 billion market more hype than reality?

Here’s the rub: $50 billion might be hyperbole, but $5 billion is still a sizable enough market to drive innovations that health systems can harness to engage patients, better manage populations and ultimately improve care and the bottom line.  When the Centers for Medicare and Medicaid Services revealed that it would start paying, under CPT code 99490, for “non face-to-face care coordination services,” one might have expected providers to rush en masse to cash in on what appears to be reasonably easy revenue. In certain instances, 99490 affords healthcare organizations to bill CMS for services they were already providing essentially for free.

That did not exactly happen in the chronic care management program’s first year. One reason, of course, is that CMS only gave the industry about 4 months notice that 99490 would kick in on January 1, 2015 – and even then it was essentially, if perhaps accidentally, advertised as a new telehealth code.

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