The MAO must have a chronic care improvement program (CCIP).

The Basics

The URAC standard supporting this CMS standard, MAP-CCIP1, requires that your organization have a chronic care improvement program ("CCIP") that is relevant to your organization's Medicare Advantage population.  That program must use criteria that include ways for your organization to identify enrollees with multiple or severe chronic conditions that your CCIP could help.

Management Tips

Make sure your P&Ps fully describe the program and have all the elements required by URAC and CMS.

URAC Accreditation Tips

For the desktop review, it will be sufficient to submit your CCIP's P&Ps, criteria, and program evaluation.  In addition, you should submit sample data reports and examples off quality committee minutes showing that the committee reviewed CCIP reports.  Sample completed health assessments and a list of diagnoses that serve as a signal to admit MA enrollees into your CCIP should be included.  

During the onsite review, the reviewer will examine the CMS-supplied form that documents the activity of your CCIP.  He/she is also likely to review case files (as many as 30) and interview staff members to determine:

• How you identified the conditions
• Whether you admit enrollees with multiple conditions into the program
• How you inform providers and enrollees of the program
• The services your participating enrollees receive
• Your program's objectives
• What outcomes your CCIP has demonstrated