Survey on Caring for Complex Medicare Patients

SmartCCM issues results of a survey of 500 primary care physicians regarding challenges in caring for Medicare beneficiaries with multiple chronic conditions.   (SmartCCM Report)  The survey was conducted in the context of the new Medicare reimbursement for care management activities.  The physicians were asked first about the biggest challenges they face in caring for these patients.  63% said it was the lack of time to work with patients to help them understand what the patient needs to do to maximize the outcomes of their treatment plan.  56% said it was the complexity of managing multiple chronic conditions, where there can often be conflicting treatment needs for different diseases.  32% said patients’ failure to follow treatment plans and medication schedules.  Half of the doctors were not yet aware that Medicare now reimburses for even non-face-to-face time in managing chronic care patients, which must reflect just how hectic primary care physicians’ schedules are.  38% said they do not routinely contact this cohort of patients between visits.  Of those who do, 24% do so personally and 37% have an office staff member check on the patient.  For this group of patients, less than 50% of doctors say that a caregiver is present during patient visits even half the time, suggesting that there often are not people other than the patient who can help monitor compliance with care plans.  Physicians say that about 75% of their patients with two or more chronic diseases are somewhat compliant with their care plan.  Only 5% are extremely compliant.  The results suggest that there is ample room to improve the efficacy of care plans and that physicians’ may not be taking full advantage of the additional reimbursement available to them if they spend more time working with patients on these issues.