Chronic Care Management

Every day, more people learn they have health conditions that may stay with them for the rest of their lives. The numbers have grown so large that the medical field has begun offering specialty care for these patients under chronic care management.

Person gripping their hand in pain. Bates, Miller, & Sims - Services, Chronic Pain Management

What is Chronic Care Management?

To answer this question, you must first understand why someone might need chronic care and how that differs from acute care. Let’s look at the definition of each:

Acute care: “Acute care is a level of health care in which a patient is treated for a brief but severe episode of illness, for conditions that are the result of disease or trauma, and during recovery from surgery.” – From Connecticut’s Office of Health Care Access.

Chronic care: “Chronic diseases are defined broadly as conditions that last on2 (1) year or more and require ongoing medical attention or limit activities of daily living or both.” – From CDC National Center for Chronic Disease.

When we think of hospital visits and treatment, those conditions putting patients in their care generally fall under the acute care definition. Here at Bates, Miller & Sims, our doctors, and other providers help their patients manage ongoing conditions that fall under chronic care.

Conditions that qualify

Conditions that result in needing chronic care include, but aren’t limited to, the following:

  • Arthritis
  • Heart disease
  • COPD
  • Asthma
  • Diabetes
  • Osteoporosis
  • Cancer
  • Skin issues (Dermatology)
  • Insomnia

A chronic condition may sometimes resolve over time through medication, surgery, physical therapy, or other treatment. However, until resolution or for those conditions that exist for life, you need help managing your health. Our chronic care management services help patients live fuller life beyond their condition.

What to Expect in a Chronic Care Management Visit?

Because chronic care management requires regular visits to our medical facilities, it’s helpful to know what to expect. Most visits with our health care providers will include the following discussions:

  • Your overall health status, including your chronic condition.
  • Measurement of vital signs and review of any test results.
  • Establishment or review of your chronic care plan
  • Review and discussion of how your chronic condition affects your everyday life.
  • Discuss any changes to lifestyle or treatment in order to improve your condition.

Learn More About Chronic Care Management

We’ll tackle some specific questions about chronic care below. But for more information or questions you don’t see in our list, call our office at (606) 365-1547 or contact us online.

Chronic Care FAQs

Medicare considers chronic care management to be a service of specific care providing coverage for patients with at least two chronic conditions. These conditions require a continuous relationship with a medical care team.

According to CMS.gov, there are 15 conditions that qualify for chronic care management. If you see your condition on this list, contact our office about treatment.

  1. Chronic alcohol and other drug dependence
  2. Certain autoimmune disorders
  3. Cancer excluding pre-cancer conditions
  4. Certain cardiovascular disorders
  5. Chronic heart failure
  6. Dementia
  7. Diabetes mellitus
  8. End-stage liver disease
  9. End-stage renal disease requiring dialysis (all modes of dialysis)
  10. Certain severe hematologic disorders
  11. HIV/AIDS
  12. Certain chronic lung disorders
  13. Certain chronic and disabling mental health conditions
  14. Certain neurologic disorders
  15. Stroke

Getting Medicaid to cover care depends upon the state in which you live. For most of our clients, Kentucky Medicaid does cover chronic care management.

Yes, Medicare covers chronic care management. To learn more about this read this brochure from the CMS.

Chronic Care Providers

KIDS WELLNESS

Child wellness check-ups can be scheduled annually or situationally. Our pediatric doctors and staff are available for your children when they are sick, and when they are well.

OB/GYN

Offering both obstetrics and gynecology services specializing in pregnancy and female reproductive health. We provide a wide range of procedures for women’s health.

URGENT CARE

We welcome walk-ins and are open convenient hours to better serve you and your family. We offer a wide range of non-emergency services for a variety of urgent care conditions.

Our Providers

Learn more about our network of family physicians, family nurse practitioners, obstetricians, and physician assistants.