What is Community Health Integration (CHI)?
A Medicare-reimbursed program that pays for addressing the social determinants of health preventing your patients from following their care plans.
Activate CHI for Your PracticeCHI: What It Is and Why It Matters
Community Health Integration (CHI) is a CMS program that reimburses physicians and qualified healthcare providers for addressing the social determinants of health (SDOH) that prevent Medicare patients from following their care plans.
Transportation, housing instability, food insecurity, financial stress, and social isolation all qualify when properly documented as directly affecting a patient's ability to adhere to their treatment plan. CMS introduced CHI as part of its recognition that clinical care alone cannot close the gaps that cause poor Medicare patient outcomes.
What CHI Means for Qualifying Medicare Members
CHI helps Medicare members with everyday challenges that affect their health, such as getting rides to doctor appointments, finding food assistance, or connecting with housing and community resources so they can stay healthier at home.
Who Qualifies for CHI?
Any Medicare patient with documented unmet social needs that are affecting their treatment plan. Unlike CCM, there is no minimum chronic condition requirement. CHI has a broad eligibility base — making it one of the most accessible new Medicare programs for practices with diverse patient panels.
CHI is Covered Under Medicare Part B
Medicare Part B Coverage
CHI services are fully covered under Medicare Part B as a billable care coordination program authorized by CMS.
Medicare beneficiaries typically pay 20% of the approved amount after meeting their annual Part B deductible. Medicare covers 80%.
When CHI Services Are Needed
CHI is appropriate when a patient's medical condition is impacted by unmet social needs such as housing, transportation, food insecurity, or financial barriers.
Your physician must document that these social barriers are directly affecting the patient's ability to manage their health condition.
CHI is one of three core Medicare care coordination programs designed to improve patient outcomes and reduce costs through holistic care management.
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