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Chronic Care Management

Chronic Care Management coordinates care under a single healthcare provider and involves a whole team of resources to encourage and provide needed assistance

The patient must be enrolled in Medicare and have two or more chronic diseases, that, if not managed, would lead to a significant decline in their health. The patient developes their own plan of care with goals they wish to attain.

Examples of chronic conditions include, but are not limited to:

  • Alzheimer's disease and related dementia
  • arthritis
  • asthma
  • atrial fibrillation
  • autism spectrum disorders
  • cancer
  • cardiovascular disease
  • chronic obstructive pulmonary disease
  • depression
  • diabetes
  • hypertension (high blood pressure)
  • infectious diseases such as HIV/AIDS
  • lupus
  • multiple sclerosis
  • sleep apnea

Patients must have a primary care provider that practices at one of the Campbell County Medical Group clinics, be enrolled in Medicare and meet the program’s health criteria.

Call Danielle Wood at 307-688-3670 for more information about Chronic Care Management; fax 307-688-5074.

The Centers for Medicare & Medicaid Services (CMS) recognizes Chronic Care Management (CCM) as a critical component of primary care that contributes to better health and care for individuals.

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