YMCA Chronic Care Programs Now Covered by Medicare

Livestrong members at the YMCA of Western North Carolina.

Seniors in Western North Carolina have more access to life-changing chronic care management programs now that the YMCA of Western North Carolina is a Medicare provider.

“The Y’s evidence-based programs for falls prevention, chronic diseases such as hypertension and diabetes, and cancer survivorship are now covered by Medicare,” said Tim Blenco, chief operating officer of the YMCA of WNC. “That means Medicare will cover these programs for people age 65 and over with a physician’s referral.”

Chronic care management, or CCM, services are a mandatory benefit on all types of Medicare insurance. The YMCA will start billing Medicare for CCM services in late March. Services are available at all seven YMCA of WNC locations in Buncombe, Henderson, and McDowell counties.

The YMCA of Western North Carolina is the first Y in North Carolina to become an approved Medicare provider, a journey that began more than eight years ago with the formation of the Y’s Population Health department.

“The Y is committed to improving the health of our community and ensuring that more people have access to programs that can transform their lives,” said YMCA of WNC Board Chair Charles Frederick. “Being a Medicare provider is a huge leap forward toward that goal, and helps ensure the sustainability of our chronic care programs for everyone who can benefit from them. The Board of Directors and I are proud of the work our dedicated staff has done to get us to this point. We will be setting an example for many Ys across the country to follow.”

The Y has also begun the process to become a credentialed Medicaid provider, Blenco said. “This will enable us to serve even more people and to ensure that everyone has access to our programs, regardless of income.”

The YMCA of WNC is also credentialed with Healthy State employee benefit plans and is completing the process with other commercial health insurance providers to incorporate its chronic disease programs as in-network benefits.

Blenco said the Y is grateful for the support its healthcare partners have provided for the Y’s clinical integration efforts.

“Mission Health, Blue Ridge Community Health, Carolinas HealthCare System Blue Ridge, and Pardee Hospital have been instrumental not only in piloting these programs but in incorporating Y services into treatment plans,” he said. “Mission has been a partner in this effort from day one. Their willingness to collaborate to address critical issues in our community combined with their investment to conduct a medical study on the Taking Control of Type 2 diabetes program was a catalyst to get us to this point. Healthy State then saw the value of our programs and incorporated them into their plan designs. Those were bold moves that speak to the innovative nature of healthcare providers in western North Carolina.”

Medicare patients are encouraged to speak with their healthcare provider about getting a referral to chronic care management programs at the Y. To learn more, contact the Y at 828 251 5910 or [email protected].