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. 2024 Sep;72(9):2730-2737.
doi: 10.1111/jgs.19066. Epub 2024 Jul 9.

Use of chronic care management service among Medicare beneficiaries in 2015-2019

Jieun Jang  1   2 , Ellen P McCarthy  1   3 , Brianne Olivieri-Mui  1   4 , Sandra M Shi  1 , Chan Mi Park  1 , Gahee Oh  1 , Stephanie Denise M Sison  1   5 , Dae Hyun Kim  1   3
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Use of chronic care management service among Medicare beneficiaries in 2015-2019

Jieun Jang et al. J Am Geriatr Soc. 2024 Sep.

Abstract

Background: The Centers for Medicare and Medicaid Services (CMS) introduced chronic care management (CCM) services in 2015 for patients with multiple chronic diseases. Few studies examine the utilization of CCM services by geographic region, sociodemographic, and clinical characteristics.

Methods: We used 2014-2019 Medicare claims data from a 5% random sample of fee-for-service beneficiaries aged 65 years or over. We included beneficiaries potentially eligible for CCM services because they had multiple chronic conditions (1,073,729 in 2015 and 1,130,523 in 2019). We calculated the proportion of potentially eligible beneficiaries receiving CCM service each year for the total population and by geographic region, sociodemographic, and clinical characteristics.

Results: The proportion of beneficiaries with two or more chronic conditions receiving CCM services increased from 1.1% in 2015 to 3.4% in 2019. The increase in CCM use was higher in the southern region, among dually eligible beneficiaries and beneficiaries with a greater burden of chronic conditions (2-5 conditions vs ≥10 conditions: 0.7% vs 2.0% in 2015; 2.1% vs 7.0% in 2019) and frailty (robust vs severely frail: 0.6% vs 3.3% in 2015; 1.9% vs 9.4% in 2019). Nearly one out of five recipients did not continue CCM service after the initial service.

Conclusion: We found that CCM service is being used by a very small fraction of eligible patients. Barriers and facilitators to more effective CCM adoption should be identified and incorporated into strategies that encourage more widespread use of this Medicare benefit.

Keywords: Delivery of Health Care; Medicare; chronic care management; chronic disease.

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Conflict of interest statement

CONFLICT OF INTEREST STATEMENT

Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG071809-02S1 and K24AG073527, and the Korea Health Technology R&D Project grant through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI21C1234 to Dr. Jang).

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