Chronic Care Management Program

Chronic Care Management Programs

Excel Medical Center realizes care management is one of the critical components of primary care that contributes to better health for our patients.

Chronic care management services include minimum 20 minutes of clinical staff time directed by a physician or other qualified health care professional, per calendar month, with the following required elements:

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

  • Alzheimer’s disease and related dementia
  • Arthritis (osteoarthritis and rheumatoid)
  • Asthma, Atrial fibrillation
  • Autism spectrum disorders
  • Cancer
  • Chronic Obstructive Pulmonary Disease
  • Depression
  • Diabetes
  • Heart failure
  • Hypertension
  • Ischemic heart disease and Osteoporosis.

2/3 of Medicare beneficiaries has 2 or more chronic conditions.

To qualify, Patients must have multiple (two or more) chronic conditions expected to last at least 12 months or until the death of the patient, and that place the patient at significant risk of death, acute exacerbation/decomposition, or functional decline are eligible for the CCM service.

Please be aware that in order to qualify for our CCM program patient must have only Medicare (no supplemental insurance).


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