Moultrie doctors join chronic care program

MOULTRIE, Ga. — Four Colquitt Regional affiliated medical practices are now participating in a Chronic Care Management (CCM) program in partnership with Allscripts.

Moultrie Pulmonology, the Kirk Clinic, Colquitt Regional Primary Care and Southern Neurology & Neurosciences are all participating in the program. Under CCM a care team guided by physicians will help patients with chronic conditions like diabetes, COPD, high blood pressure, anxiety, high cholesterol, obesity and asthma.

“We recognize that effectively managing patients with chronic conditions takes more than routine face-to-face visits to a doctor’s office,” said Colquitt Regional President and CEO Jim Matney. “This program will allow us to provide outreach, telephone conversations, medication reconciliation and coordination among caregivers. It’s a comprehensive approach that will hopefully keep patients’ health under control and prevent a hospital visit.”

The program is available to Medicare patients, and more than 400 individuals have already signed up to participate, according to a hospital press release. Those enrolled will now have access to care services by telephone. The clinician providing care will have full access to a patient’s plan, care, and medication through the system. The care coordination team will also conduct monthly medication reconciliation to audit the medications the patient is taking. This ensures the patients are on the proper doses of the correct medications and that drug interactions are reduced.

The care coordination team will also help patients and family members understand the healthcare they are receiving, including what to expect with labs, procedures, surgeries or a hospital stay, the hospital said. This team will function as a patient advocate and answer questions or offer advice about a patient’s health.

While four medical practices are now participating in the program, additional physicians will be coming on board in the future, the hospital said. Those interested in enrolling in the program can sign up during their next office visit if they are a patient at Moultrie Pulmonology, the Kirk Clinic, the Primary Care Clinic and Southern Neurology & Neurosciences.

Richard Bass, chairman of the Colquitt Regional Board of Trustees, said this a step in the right direction.

“One of the expected outcomes of this program is reduced ER visits and unnecessary hospital stays or readmissions,” said Bass. “Better control of chronic conditions and improved medication monitoring will ultimately help reduce the cost of healthcare.”

For additional information about the Chronic Care Management program please contact the Colquitt Regional Physician Referral Line at 229-891-9362.

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