To the Editor Clinicians who treat Medicare patients with chronic conditions now have an incentive to better coordinate their complex care. As Dr Aronson and colleagues1 suggested in their Viewpoint, meeting the requirements of the Medicare chronic care management fee will require some new skills and resources.
Steps 1 through 3 in their proposed care needs assessment (determine the likelihood of care and coordination needs, establish goals of care, assess care needs) should be standard practice. But the fourth step (matching resources to needs) fails in 2 respects: it does not recognize what family caregivers actually do and sets out unrealistic expectations of what is available for Medicare beneficiaries.
Reinhard S, Levine C. Chronic Care Management for Medicare Patients. JAMA. 2015;313(22):2286. doi:10.1001/jama.2015.4975