What is Chronic Care Management (CCM)?
Chronic Care Management
Chronic care management is a specific care management service that provides coverage for patients with two or more chronic conditions for a continuous relationship with their Denver Digestive Health Specialists care team. This includes creating a comprehensive care plan, interactive remote communication and management (usually over the phone), treatment and medication management, and coordination of care between providers.
Chronic care management is beneficial for patients in terms of ongoing health and wellness support, increased access to appropriate medical resources, enhanced communication with members of their care team, reduction in emergency room visits and hospitalization or readmissions, and increased engagement in their own healthcare.
Denver Digestive Health Specialists CCM Services
GI Alliance provides the following Chronic Care Management services for patients with chronic GI and Liver issues only.
In-Home Care As Needed
Interdiciplinary Care Team
Remote Montioring & Virual Visits
Health Coaching
Care Coordination
Outcomes & Reporting
In-Person Assessments
Chronic GI issues such as:
- Inflammatory bowel disease (IBD)
- Irritable bowel syndrome (IBS)
- Pancreatic exocrine insufficiency (PEI)
Chronic Esophageal issues such as:
- Achalasia
- Barrett’s esophagus
- Esophageal cancer
- Gastroparesis
- Gastroesophageal reflux disease (GERD)
Chronic Liver issues such as:
- Non-alcoholic fatty liver disease (NAFLD)
- Obesity/metabolic syndrome
Who is eligible for CCM?
All patients who have two or more qualifying chronic health conditions that are expected to last 12 months and the conditions put them at risk of flare or decline are eligible for CCM services.
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