Chronic Care Management: A pathway to improved health

Chronic diseases such as diabetes, hypertension, cardiovascular disease, and asthma are among the leading causes of death and disability worldwide. These conditions require ongoing , proactive management and care to prevent complications and improve quality of life. In response to this growing healthcare challenge, the Centers for Medicare & Medicaid Services created the Chronic Care Management (CCM) Program to provide wraparound care for patients with multiple chronic conditions. 

In our mission to make lives better, the UT Health San Antonio Primary Care Center has implemented the Chronic Care Management program to enhance the overall well-being of patients with multiple chronic conditions. Our CCM program links patients with nurse care managers who, with their UT Health San Antonio primary care physicians, help patients better manage their health, spend more time focusing on their health, and increase their quality of life.

Who is eligible for the Chronic Care Management program?

Patients with Medicare, both Medicare and Medicaid, or a Medicare Advantage plan with two or more chronic conditions expected to last 12 months or for the rest of the patient’s life. You must give verbal consent.

Is there a fee for the Chronic Care Management program?

The usual cost-sharing rules apply to CCM services, so you may be responsible for the usual Medicare Part B cost sharing (deductible and copayment/coinsurance) if you do not have supplemental, or wraparound, insurance. Contact your insurance company if you have any questions about your benefits.

How to participate in the program?

Talk to your UT Health San Antonio primary care provider about CCM services and your coverage. If you are eligible and would like to participate in the program, you will provide informed consent to your provider and be enrolled. One of our team members will be in touch with you shortly after you are enrolled.

Benefits of Chronic Care Management

• Improved health outcomes

With continuous support and proactive management, patients can better control their chronic conditions, reducing the risk of complications and hospitalizations.

• Enhanced access to care

Utilizing technology and telehealth services to overcome barriers to care ensures that patients have timely access to medical advice and support, regardless of their location.

• Care coordination

A nurse care manager serves as the central point of contact for the patient, facilitating communication among the healthcare providers involved in their care, ensuring that all aspects of the patient's treatment plan are well-coordinated and that any changes or updates are communicated effectively.

• Medication management

Taking medication routinely is critical for managing chronic conditions effectively. Providers work closely with patients to optimize medication regimens, address side effects and prevent drug interactions.

• Cost savings

Chronic care management can help reduce overall healthcare costs for patients by preventing costly hospitalizations and emergency room visits.

Ask your primary care provider about the Chronic Care Management program at your next appointment. Schedule a virtual on in-person appointment with your UT Health San Antonio primary care provider using MyChart.