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The Chronic Care Improvement Program


NEWS

*The CCIP proposals should be sent to the address on the solicitation, however, we will accept proposals at the address listed on our website and waiver application. All proposals must be received by August 6, 2004. (Updated August 3, 2004)



*We are pleased to announce that CMS plans to include available beneficiary telephone numbers in the data set we will give awardees for outreach to identified intervention group beneficiaries. We estimate, but cannot guarantee, that approximately 75% of beneficiary records will include a telephone number. That was the match rate achieved by CMS providing phone numbers on a sample of 177,950 Medicare FFS beneficiaries for the 2003 CAPHS Fee-For-Service survey. In addition, for that CAPHS survey, commercial firms were able to find phone numbers for 2/3 of the 25% of beneficiaries for whom CMS did not have a phone number. (Updated June 17, 2004)



*New reports on dual eligible beneficiaries have just been posted. View Data Analyses on CCIP Populations (Posted July 28, 2004)



*We will continue to accept requests for Data Use Agreements (DUAs) through close of business on Monday, July 26. DUAs received thereafter will not be processed. CCIP proposals are due August 6, 2004. (Posted July 22, 2004)



Data Analyses of CCIP Populations:

  • Document 1: Profile of Utilization and Spending for the CCIP Populations

  • (ZIP 10Kb)
  • Document 2: Rates and Reasons for Loss of Eligibility for Participation in CCIP, 2000-2002, among Medicare Beneficiaries Eligible as of June 30, 1999

  • (ZIP 7Kb)
  • Document 3: Top 25 Episodes ranked by number of episodes and total payment amounts for CHF/Diabetes population

  • (ZIP 74Kb)
  • Document 4: Top 25 Episodes ranked by number of episodes and total payment amounts for COPD population

  • (ZIP 74Kb)
  • Document 5: Profile of Utilization and Spending for the CCIP Populations, By Medicaid Buy-In* (Dual Eligible) Status In Current Month

  • (ZIP 24Kb) New
  • Document 6: Rates and Reasons for Loss of Eligibility for Participation in Chronic Care Improvement Programs, 2000-2002, among Medicare Beneficiaries Eligible as of June 30, 1999. Start Month and End Month, by Dual Eligible Status* as of June 1999.

  • (ZIP 4Kb) New

Estimated Number of Beneficiaries Eligible for CCIP: (Updated 5/25/04)

  1. CHF and/or Diabetes (PDF 1,229 KB)
  2. COPD (PDF 1,097 KB)


An Overview:

The Chronic Care Improvement Program is an important component of the Medicare Modernization Act and demonstrates a commitment to improving and strengthening the traditional fee-for-service Medicare program. This program is the first large-scale chronic care improvement initiative under the Medicare FFS program. CMS will select organizations that will offer self-care guidance and support to chronically ill beneficiaries. These organizations will help beneficiaries manage their health, adhere to their physicians’ plans of care, and assure that they seek or obtain medical care that they need to reduce their health risks. The Chronic Care Improvement Program is referenced in Section 721 P. L. 108-173 and was created by the Medicare Modernization Act of 2003 (MMA).

Apply to Implement and Operate a Chronic Care Improvement Program

1. Download the Medicare Waiver Application (PDF 70KB)

2. Download a copy of the Federal Register Notice (solicitation); (.pdf 180KB)

3. Bidders Conference materials: Agenda and Slides (PDF, 450 KB or Zipped PowerPoint, 262 KB)

4. Request a Sample Data Set

Applicants are strongly encouraged to obtain and review a sample data set before submitting their proposals. To obtain a sample data set, download the Data Use Agreement click here (PDF 76KB) and mail a signed copy of the agreement to:

Chronic Care Improvement Program
Centers for Medicare and Medicaid Services
Office of the Administrator
C5-11-24
7500 Security Boulevard
Baltimore, MD 21244-1850


Once CMS receives the Data Use Agreement, a compact disk will be mailed to the individual listed as a "point of contact" on the Agreement. The compact disk will contain the sample data set, as well as documentation needed to use the data (YOU SHOULD RECEIVE THE CD WITHIN THREE DAYS AFTER THE DATA USE AGREEMENT IS RECEIVED BY CMS. PLEASE E-MAIL TO CCIP@CMS.HHS.GOV IF YOU DO NOT RECEIVE A CD IN THIS TIMEFRAME.) In order to get an understanding of the sample data set in advance of receiving the CD, please find "Readme" and the "Data Dictionary" below.

Frequently Asked Questions about the Chronic Care Improvement Program.

Press Release (PDF 33KB)

Submit a question or comment on the Chronic Care Improvement program to ccip@cms.hhs.gov.


Highlights of the Program

check markIn Phase I, the pilot phase, there will be approximately 10 regional CCI programs, collectively serving approximately 150,000 - 300,000 chronically ill beneficiaries, in regions where at least 10% of Medicare beneficiaries reside. The Phase I programs will operate for 3 years and be evaluated through randomized controlled trials.

check markThe program will offer self-care guidance and support to chronically ill beneficiaries to help them manage their health, adhere to their physicians’ plans of care, and assure that they seek (or obtain) medical care that they need to reduce their health risks.

check markThe programs will include collaboration with participants’ providers to enhance communication of relevant clinical information. The programs are intended help to increase adherence to evidence-based care, reduce unnecessary hospital stays and emergency room visits, and help participants avoid costly and debilitating co-morbidities and complications.

check markInitially, the programs will be focused on beneficiaries who have Congestive Heart Failure (CHF), Complex Diabetes, or Chronic Obstructive Pulmonary Disease (COPD) because these beneficiaries have heavy self-care burdens and high risks of experiencing poor clinical and financial outcomes.

check markThe new programs are NOT single-disease focused. They will be designed to help participants manage all their health problems.

check markParticipation will be entirely voluntary. Eligible beneficiaries do not have to change plans or providers or pay extra to participate. They will be able to stop participating at any time. They will not restrict access to care.

check markSelected organizations will be required to refund some or all of their fees to the federal government if they do not meet agreed-upon standards for quality improvement, savings to Medicare, and increased satisfaction levels in their assigned beneficiary populations.

check markThis is a flexible business model. Health insurers, disease management organizations, physician group practices, integrated delivery systems, and consortia of these entities or other legal entities the Secretary determines appropriate are all eligible to apply to become CCI organizations.





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Last Modified on Thursday, September 16, 2004