Quality Improvement Program: Implementation of Chronic Care Management Services in an Affordable Care Organization

2.50
Hdl Handle:
http://hdl.handle.net/10755/621590
Category:
Full-text
Format:
Text-based Document
Type:
DNP Capstone Project
Level of Evidence:
N/A
Research Approach:
Pilot/Exploratory Study
Title:
Quality Improvement Program: Implementation of Chronic Care Management Services in an Affordable Care Organization
Author(s):
Duke, Lori
Additional Author Information:
Lori Duke, DNP, FNP-C
Advisors:
Gaddis, Lorraine; Phelon, Shonda; Lester, Alena
Degree:
DNP
Degree Year:
2017
Grantor:
Mississippi University for Women
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.

Keywords:
Chronic care management program
CINAHL Headings:
Disease Management; Chronic Disease; Chronic Disease--Therapy; Program Implementation; Quality Improvement; Accountable Care Organizations
Note:
This work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.
Repository Posting Date:
2017-06-23T18:23:26Z
Date of Publication:
2017-06-23

Full metadata record

DC FieldValue Language
dc.contributor.advisorGaddis, Lorraineen
dc.contributor.advisorPhelon, Shondaen
dc.contributor.advisorLester, Alenaen
dc.contributor.authorDuke, Lorien
dc.date.accessioned2017-06-23T18:23:26Z-
dc.date.available2017-06-23T18:23:26Z-
dc.date.issued2017-06-23-
dc.identifier.urihttp://hdl.handle.net/10755/621590-
dc.description.abstract<p>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.</p>en
dc.formatText-based Documenten
dc.language.isoenen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/*
dc.subjectChronic care management programen
dc.titleQuality Improvement Program: Implementation of Chronic Care Management Services in an Affordable Care Organizationen
dc.typeDNP Capstone Projecten
thesis.degree.grantorMississippi University for Womenen
thesis.degree.levelDNPen
dc.description.noteThis work has been approved through a faculty review process prior to its posting in the Virginia Henderson Global Nursing e-Repository.-
dc.primary-author.detailsLori Duke, DNP, FNP-Cen
thesis.degree.year2017en
dc.type.categoryFull-texten
dc.evidence.levelN/Aen
dc.research.approachPilot/Exploratory Studyen
dc.subject.cinahlDisease Managementen
dc.subject.cinahlChronic Diseaseen
dc.subject.cinahlChronic Disease--Therapyen
dc.subject.cinahlProgram Implementationen
dc.subject.cinahlQuality Improvementen
dc.subject.cinahlAccountable Care Organizationsen
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