Emerging Areas of Human Health Topic 7: Chronic Disease-chronic management services-Nursing Paper Examples

Topic 7 DQ 1 (Chronic Management Services-Nursing Paper Examples)

Ensuring all eligible Medicare patients receive chronic management services (CMS) requires effective and well-organized plans and strategies to attain intended goals. The program comprises diverse procedures aligned with legal, professional, and ethical requirements and guidelines. According to Boustani et al. (2019), the plan includes evaluating the practice readiness, establishing the appropriate team, identifying eligible patients, obtaining patient consent, developing a comprehensive care plan, and documenting the bill for Medicare services (Chronic Management Services-Nursing Paper Examples).

The plan begins with evaluating the practice’s readiness to ensure that Medicare patients receive the CMS based on eligibility. This step focuses on evaluating the patients’ needs regarding Chronic Care Management (CCM), the technology employed, such as electronic health records (EHR), and the skills and training required (Agarwal et al., 2018). This approach ensures the plan possesses adequate resources for incorporating Medicare patients into the CCM system (Boustani et al., 2019). Besides, the plan involves creating an effective interdisciplinary team to ensure diverse tasks are performed sufficiently. In this case, assembling the team would facilitate implementing and managing the CCM program. The team members focus on delivering the required CCM services to eligible Medicare patients (Chronic Management Services-Nursing Paper Examples).

According to Boustani et al. (2019), identifying eligible patients to participate in the CCM program is an essential part of the plan to ensure qualified Medicare patients receive chronic management services. Some of these qualifications include suffering from two or more chronic conditions with anticipation of lasting more than one year (Boustani et al., 2019). Patient identification leads to obtaining the patient’s consent to participate in the program. In this case, a consent letter must be well understood by the patients (Chronic Management Services-Nursing Paper Examples).

Developing a comprehensive care plan would facilitate detailing the chronic conditions experienced by the patients, medical history, and required medication based on the level of Medicare qualifications (Agarwal et al., 2018). The program focuses on assessing and identifying patients with diverse chronic conditions to effectively put them under CCM with appropriate medication intervention for long-term care (Agarwal et al., 2018).

To ensure the program’s success, the care coordinator, manager, and provider will monitor and coordinate the program. Such care services comprise regular checkups on the health status, offering medication management, and enhancing referrals to various healthcare practitioners when necessary to improve the health outcomes of the patients (Chronic Management Services-Nursing Paper Examples).

The plan to ensure eligible Medicare patients receive the CCM services involves documenting and billing various services involved to report on the Medicare expenditure on the patients. Accurate documentation is essential for linking the CCM services to the qualified patients and Medicare expenditure (Boustani et al., 2019). The practice of documentation would enhance effective Medicare reimbursement procedures contributing to facilitating attaining the CCM’s goals (Chronic Management Services-Nursing Paper Examples).

Furthermore, documenting the activities involved in the program has an integral role in understanding the effects of Medicare patients missing the reception of chronic care management services. For instance, the lack of eligible Medicare patient’s access to CCM contributes to the misappropriation of expenditures and inadequate understanding of patterns in the system (Agarwal et al., 2018). Nevertheless, the spending would increase with limited use for the designated purposes (Chronic Management Services-Nursing Paper Examples).

References

Agarwal, S. D., Barnett, M. L., Souza, J., & Landon, B. E. (2018). Adoption of Medicare’s transitional care management and chronic care management codes in primary care. JAMA, 320(24), 2596. https://doi.org/10.1001/jama.2018.16116

Boustani, M., Alder, C. A., Solid, C. A., & Reuben, D. (2019). An alternative payment model to support widespread use of collaborative dementia care models. Health Affairs, 38(1), 54-59. https://doi.org/10.1377/hlthaff.2018.05154