For Patients

At SynerGRx, we understand the challenges of managing a chronic illness. Our team of board-certified clinical pharmacists can work closely with your physicians to coordinate care and help you achieve the best overall health outcomes. Our pharmacists are available to answer your questions around the clock and provide personalized care and support to meet your individual needs.

Patients: What is Chronic Care Management?

Chronic Care Management (CCM) is a Medicare program that provides beneficiaries with two or more chronic conditions access to a care coordination program at little or no cost. A chronic condition, as defined by Medicare, is a condition that:

  • Expected to last at least 12 months
  • Poses a risk of functional decline, worsening of health, complications, or death
  • Requires continuous management including the establishment, implementation, revision, and monitoring of a care plan

What are the benefits of Chronic Care Management?

CCM services allow for proactive collaboration between patients and healthcare professionals. Our pharmacists will work with you to develop a customized care plan, coordinate care with your doctor, pharmacy, and other healthcare providers, update your electronic health record, and address any medication-related questions or concerns. Additionally, CCM services may help prevent hospitalization, improve medication adherence, and provide patient and caregiver education on medications and wellness.

CCM services can be provided by pharmacists based on their extensive knowledge on chronic diseases and medications. Our clinical pharmacy staff will work directly with your primary care provider to provide these services and help you achieve your health goals.

As a patient caregiver, how will this help me?

CCM services can provide assistance to caregivers 24/7. Our pharmacy care team can help manage medication side effects, educate on new medication therapy, ensure medication refill continuity, provide adherence tools, and offer preventative care recommendations and coordination. Our pharmacists will also serve as a bridge of communication between caregivers and the primary care provider, keeping caregivers informed of changes in treatment plans, and providing guidance and support.

We strive to keep you informed and serve as a bridge of communication between you and the primary care provider, ensuring that any changes in treatment plans are communicated effectively. Our team is able to provide personalized advice and interventions, taking into account the specific needs of the patient. By working directly with the primary care provider, we are able to provide comprehensive care and support, allowing you to focus on the well-being of your loved one and reduce some of the burden of being a caregiver.

Frequently Asked Questions

Who should participate?

Anyone taking multiple medications with two or more chronic conditions can benefit from Chronic Care Management services. Our services can help you keep a healthy lifestyle by optimizing care and assisting with medications.

How do I enroll?

Written or verbal consent must be provided to formally initiate services. This can be completed in one of two ways: fill out the form provided below with your information or express your interest during your upcoming doctor’s visit to provide consent. You only need to enroll once into the program.

Who pays for these services?

Medicare and Medicaid provide payments for the services provided by your doctor and most beneficiaries pay little or no cost.

What is expected of me as a patient?

You must provide verbal or written consent to initiate services.

You must be open to discussing your health with the care team when contacted.

Will I have to change doctors?

No. However, Chronic Care Management services can only be provided by one doctor and thus, you cannot provide consent to multiple providers.

What if I change my mind?

You can request to stop Chronic Care Management at any time.

For Providers

Why Pharmacists?

Pharmacists play a vital role in the healthcare industry, particularly as the need for care for the aging population continues to grow. Medications play a significant role in treatment, with the World Health Organization estimating that medication nonadherence accounts for up to 50% of treatment failures and 25% of hospitalizations each year in the United States.

Clinical pharmacists, with their expertise in medication management, can identify and address gaps in patient care, including medication adherence and compliance, disease state management, and preventative measures such as immunizations and smoking cessation. They can also coordinate care for patients with chronic conditions and provide guidance on drug efficacy, safety, and interactions.

In addition, pharmacists play an important role in improving patient care by working in collaboration with physicians and other healthcare professionals to provide a comprehensive, holistic approach to treatment. By actively engaging with patients and addressing their specific needs, they can improve the quality of care and increase patient satisfaction.

In summary, by focusing on patient-centered care, pharmacists can improve health outcomes and reduce healthcare costs by helping patients stay on track with their medication and providing targeted, effective treatment. Their expertise and collaboration with other providers can improve patient experience and satisfaction.

CMS Quality Metrics

The Center for Medicare and Medicaid Services (CMS) has implemented quality metrics through the Merit-Based Incentive Payment System (MIPS) to tie payments to quality and cost-efficient care, with the goal of driving improvements in care processes and health outcomes, and reducing the overall cost of care. Health professionals and organizations with good quality metrics will receive financial incentives, while those with low ratings may face penalties.

Why Chronic Care Management?

Chronic Care Management (CCM) is an effective tool for impacting the MIPS performance, as it involves the provision of care management and coordination of services for patients with two or more chronic conditions. CCM enables patients to have access to a dedicated team of healthcare professionals who can help them stay on track for good health. Services provided under CCM include transition of care, medication reconciliation, a comprehensive care plan, patient support between office visits, coordination of care with other health professionals and pharmacies, assistance with insurance prior authorizations and patient assistance programs, and monitoring of adherence and health outcomes.

What are the benefits to physicians?

Implementing CCM can lead to a range of benefits. Studies have shown that CCM increases primary care physician visits by one appointment per year, while decreasing hospitalizations and emergency department visits. Having a dedicated staff for care between office visits also allows for early intervention in the event of noncompliance with treatment plans, which can negatively impact outcomes. Other benefits of CCM include improved coordination of care, enhanced patient experience and empowerment, strengthened patient-provider relationships, the ability to bill for between-visit care, and the identification of omissions in care. Additionally, it allow providers to focus on critical and high-reimbursement-related activities, seamless continuity of care to minimize errors, improve outcomes, and reduce costs.