Responses for DNP 810 Topic 1 and 2 Week 7-chronic care management-nursing Paper Examples

DQ 1 Responses (Chronic Care Management-Nursing Paper Examples)

Response to AB

Hello AB,

Thank you for sharing an insightful discussion. Research indicates that increasing access to affordable care for all Americans decreases costs associated with poor health, medical complications, and high mortality rates. Over two-thirds of the 40 million Medicare fee-for-service patients nationwide have several chronic illnesses (Reddy et al., 2020). These patients commonly experience fragmented treatment, accounting for over 90% of all Medicare costs (Reddy et al., 2020). To address these problems, Medicare started paying doctors in 2015 via chronic care management (CCM) codes for chronic care management (Chronic Care Management-Nursing Paper Examples).

Additionally, to assist the more than 180,000 primary care doctors who care for Medicare patients nationally, chronic care management offers longitudinal, non-visit-based care, such as ongoing disease management and clinician coordination (Reddy et al., 2020). Patients with numerous chronic diseases can receive chronic care management from clinicians once a month, and the services must include the establishment, monitoring, or revision of an extensive care plan. If patients fail to receive CCM, healthcare spending might increase due to increased hospitalizations, readmissions, and morbidity (Chronic Care Management-Nursing Paper Examples).


Reddy, A., Marcotte, L. M., Zhou, L., Fihn, S. D., & Liao, J. M. (2020). Use of Chronic Care Management Among Primary Care Clinicians. Annals of Family Medicine18(5), 455–457.

Response to BV

Hello BV,

Your discussion is comprehensive and informative. The CCM services are essential elements of primary care that advance greater health and lower overall healthcare costs, according to the Centers for Medicare & Medicaid Services (CMS). I agree that implementing CCM has been challenging so far. Medicare has continued to emphasize the code in payment policy despite adopting chronic care management has been slow thus far, with just 16,459 physicians providing these services to 684,584 Medicare patients over the first two years (2015–2016) (CMS, 2022) (Chronic Care Management-Nursing Paper Examples).

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Chronic Care Management-Nursing Paper Examples
Chronic Care Management-Nursing Paper Examples

Over time, policymakers have broadened chronic care management codes to cover complex care and allow team members who are not doctors to provide chronic care management services. The 2020 Medicare physician price schedule expands services to patients with a single medical condition and raises payments for chronic care management (CMS, 2022). I agree that technology can help bolster CCM implementation and help it achieve the intended objective (Chronic Care Management-Nursing Paper Examples).


CMS. (2022, September 23). Chronic care management and connected care. Centers for Medicare & Medicaid Services | CMS.

Response to MF

Hi MF,

Thank you for an educative and elaborative discussion. Indeed, chronic diseases contribute to significant morbidity and mortality in the United States. Managing chronic diseases is costly for average Americans, and Medicare tries to increase access to disease management services through chronic care management (Chronic Care Management-Nursing Paper Examples).

In addition, since World War II, more people have reached the Medicare eligibility age attributed to The Baby Boom, a period of increased births from 1946 to 1964. Over 20% of Americans will be 65 or older by 2030 (Feke, 2022). That will likely lead to an increase in chronic diseases. People with chronic medical issues are likelier than those without to use more healthcare services. They can require more frequent medical follow-up appointments, hospital stays, specialist referrals, testing, and medications (Chronic Care Management-Nursing Paper Examples).

I agree that chronic care management is a partnership with public and private providers to extend disease management services to Medicare beneficiaries. CCM has helped improve the health of these individuals. Those participating in the Chronic Care Management program are 2.3% less likely to require hospital observation or emergency department care. Their probability of being hospitalized as an inpatient fell by 4.7% (Feke, 2022). Therefore, it is necessary to increase the effectiveness of CCM to help more people with chronic illnesses (Chronic Care Management-Nursing Paper Examples).

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Feke, T. (2022, September 23). Chronic care management and connected care. Centers for Medicare & Medicaid Services | CMS.

DQ 2 Responses

Response to SB


Thank you for an informative and insightful discussion. The aging population is among the challenges the healthcare system experiences today. This problem is expected to increase as more people reach 65 by 2030. Older age is associated with increased chronic illnesses that require constant management and frequent provider visits.

I agree that this population faces multiple healthcare access and affordability disparities, affecting their ability to manage illnesses and lead a quality life. I agree that increasing the workforce and creating partnerships with public and private businesses can bolster efforts to address the aging population and increase healthcare needs. Older patients have the lowest concentration of healthcare workers, and increasing this concentration would help address their complex healthcare needs.(Chronic Care Management-Nursing Paper Examples)  


Fulmer, T., Reuben, D. B., Auerbach, J., Fick, D. M., Galambos, C., & Johnson, K. S. (2021). Actualizing better health and health care for older adults. Health Affairs40(2), 219-225.

Response to TR

Hi TR,

I enjoyed reading your discussion for its unique approach to the question. I agree that remote care increased rapidly during the COVID-19 pandemic as healthcare workers sought to ensure care continuity and reduce the risk of virus transmission. Telehealth services are in wider use today, which can help improve healthcare delivery among older adults over 65 years. I concur that telehealth is more convenient, has indifferent health outcomes to physical visits, and enhances access to care. Implementing telehealth services diligently would be great for this patient population, which also reports mobility issues (Wardlow et al., 2023) (Chronic Care Management-Nursing Paper Examples).

Research has shown that telehealth’s perceived benefits outweigh its drawbacks in the care of older people. Therefore, guidance and resources are necessary to improve telehealth for older individuals. Indeed, telehealth and physical visits should complement one another instead of one or the other to increase success rates and offset the drawbacks of using telehealth, including good internet requirements (Chronic Care Management-Nursing Paper Examples).  

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Wardlow, L., Roberts, C., & Archbald-Pannone, L. (2023). Perceptions and uses of Telehealth in the care of older adults. Telemedicine and e-Health29(8), 1143-1151.

Response to Classmate 3


Thank you for the great post. I concur that a community health worker–based chronic care management model can help improve healthcare delivery for older adults. Community health workers (CHWs) help lower healthcare expenditures, especially for patients with high initial costs and underserved and minority populations (Chronic Care Management-Nursing Paper Examples).

They can also enhance patients’ health by offering ongoing behavioral support throughout their medical treatment (Crespo et al., 2020). Therefore, implementing a CHW-based care model would help train community health workers to offer care for older patients. This strategy is associated with improved outcomes and lower costs for older patients with chronic illnesses (Chronic Care Management-Nursing Paper Examples).


Crespo, R., Christiansen, M., Tieman, K., & Wittberg, R. (2020). An emerging model for community health worker–based chronic care management for patients with high health care costs in rural Appalachia. Preventing chronic disease17, E13.

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