Comprehensive Care Management Solutions
We help practices, health systems, ACOs, and employer groups implement and optimize care management programs that improve quality metrics, patient satisfaction, and financial performance.
Chronic Care Management (CCM)
Support patients living with multiple chronic conditions through ongoing care coordination, monthly touchpoints, medication review, and personalized care planning.
Benefits
Improved patient engagement
Better chronic disease outcomes
Additional recurring revenue
Reduced hospital utilization
Remote Patient Monitoring (RPM)
Extend care beyond the office through connected devices and proactive monitoring.
Benefits
Earlier intervention
Better blood pressure and diabetes management
Increased patient adherence
Enhanced provider visibility
Principal Care Management (PCM)
Focused care management for patients with a single high-risk chronic condition requiring intensive support.
Ideal for
Oncology
Cardiology
Pulmonology
Neurology
Specialty practices
Behavioral Health Integration (BHI)
Integrate behavioral health support into primary care through structured patient outreach, screening, monitoring, and care coordination.
Benefits
Improved mental health outcomes
Better whole-person care
Additional reimbursement opportunities
NYS Collaborative Care Model (CoCM)
Nurse-led behavioral health programs designed to meet New York State requirements and improve access to mental health services.
Ideal for
Behavioral health care management
Psychiatric consultation support
Measurement-based care
Collaborative provider engagement
Transitional Care Management (TCM)
Reduce readmissions and improve post-discharge outcomes through structured patient follow-up and care coordination.
Services include
Hospital discharge follow-up
Medication reconciliation
Care plan review
PCP appointment coordination
Patient education
Annual Wellness Visits (AWV)
Our nurse-led AWV solution helps practices improve preventive care delivery while reducing provider workload. Delivered by RNs and LPNs.
Ideal for
Increased patient satisfaction
Improved quality scores
Enhanced preventive care compliance
Additional practice revenue