Chronic Care Management

What is Chronic Care Management (CCM)?

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 care team. This includes formulating a comprehensive care plan, interactive remote communication and management (usually over the phone), medication management, and coordination of care between providers.

GI Alliance CCM Services

We provide CCM services for patients with chronic GI and Liver diagnoses only.

CCM-Chart
Chronic GI diagnoses include:

  • Irritable Bowel Disease (IBD)
  • Irritable Bowel Syndrome (IBS)
  • Pancreatic exocrine insufficiency (PEI)
  • Crohn’s Disease

Chronic Esophageal Disorders such as:

  • Achalasia
  • Barrett’s Esophagus
  • Esophageal Cancer
  • Gastroparesis, Gastroesophageal Reflux Disease (GERD)

Chronic Liver Diseases such as:

  • Non-Alcoholic Fatty Liver Disease (NAFLD)
  • Obesity/metabolic syndrome

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Who is eligible for CCM?

All patients who have two or more qualifying chronic health conditions that are expected to last 12 months or until end of life and the conditions put them at risk of flare or decline are eligible for CCM services.
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