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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) 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: 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.
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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. |
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In 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. The 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. The 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. Initially,
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. The new programs are NOT single-disease focused. They will be designed to help participants manage all their health problems. Participation 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. Selected 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. This 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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