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Chronic Care Management at Lane Family Practice

Chronic Care Management at Lane Family Practice

Chronic Care Management is a coordinated care program designed by Medicare to help patients manage their chronic health conditions. The program gives patients care and support between appointments with their primary care physician, in an effort to minimize hospitalizations and emergency room visits.

A chronic condition is an ongoing, long-lasting health condition that, without proper care, can negatively impact an individual’s health and quality of life. A few examples of chronic conditions include heart disease, hypertension, diabetes, asthma, and arthritis.

Benefits of participating in the Chronic Care Management program include:

  • Personalized assistance from a dedicated healthcare team who will work with you to create your care plan and help you meet your health goals
  • 24/7 emergency access to a healthcare professional
  • Monthly phone check-ins between visits to keep you on track
  • At least 20 minutes per month of Chronic Care Management services
  • Help with medication management

To be eligible for the Chronic Care Management Program a patient must be a traditional Medicare beneficiary, be a patient at Lane Family Practice, and have two or more chronic conditions that are expected to last at least 12 months or until the end of life. If you are unsure if you qualify for the program, please speak with your primary care provider. Patients are able to opt out of the program at any time as there is no long-term commitment.

“At Lane Family Practice, we are passionate about empowering patients with education and resources to best manage their health and healthcare,” says Amy Rome, RN, chronic care nurse navigator. “Our Chronic Care Management Program was established in 2017, and as the first program of its kind in the area we have successfully served hundreds of patients. We know and recognize that a dedicated nurse and physician team decreases emergency room visits, hospitalizations, and readmission rates. I am proud to be part of this amazing team, and I look forward to our working with you."

Chronic Care Management is a cost-sharing program, which means it is subject to your annual Medicare deductible and copays. The majority of Medicare patients have secondary insurance providers which often cover the cost of Chronic Care Management copays. It is best to review exactly what your insurance plan covers. Patients enrolled in a Medicare Advantage program should contact their insurance provider for information regarding specific program benefits provided under their coverage.

Need help, have questions, or want more information? Please call Amy Rome, RN, Chronic Care Nurse Navigator at Lane Family Practice, 225-654-3607, ext. 5155.