Payors face rising chronic disease prevalence, competitive Star rating pressure, enrollment churn, unaddressed SDoH needs, and unpredictable cost spikes from avoidable acute events. Plans need a structured, scalable way to stabilize chronic populations and improve performance across clinical, financial, and operational domains.
CCM provides the following benefits to Payors:
- Strengthening Quality and Star Performance: CCM improves member stability through monthly engagement that boosts blood pressure and A1c control, medication adherence, COPD/CHF stabilization, preventive care completion, and SDoH intervention, directly enhancing HEDIS and Star metrics.
- Reducing Avoidable Utilization: CCM identifies early warning signs like missed medications, worsening symptoms, mental health deterioration, and SDoH needs, reducing inpatient admissions, ED visits, readmissions, and exacerbations.
- Improving Member Experience and Retention: Monthly outreach strengthens CAHPS scores, Star Ratings, and member loyalty.
- Stronger Risk Adjustment and Documentation: CCM uncovers undiagnosed conditions, disease progression, medication issues, and social barriers, improving RAF accuracy when communicated appropriately to provider partners.
How Kencor Health Helps Payors Deploy CCM at Scale
Kencor Health deploys an integrated care management team composed of care coordinators, RNs/LPNs for clinical escalation, clinical coaches, multilingual support staff, and supervising clinicians who collaborate closely with your existing care teams to ensure seamless, coordinated delivery of CCM services.
Kencor Health Provides A Comprehensive, Scalable Platform including:
- Bi-directional integration with EHRs and provider systems
- Member stratification
- Automated workflows
- SDoH documentation
- Compliance tracking
- Analytics aligned with HEDIS and Star measures
Kencor offers fully managed operation where our team manages eligibility, enrollment, monthly interactions, documentation, compliance checks, and quality reporting.
Financial Benefits for Payors
CCM delivers:
- Higher Star Ratings and bonus revenue
- Lower total cost of care
- More accurate risk adjustment
- Reduced churn
- Fewer catastrophic claims
- Improved value-based provider performance
A Proactive Model for the Future
A well-designed CCM program is more than a regulatory construct. It is the foundation for a more predictive, preventive, member-centered health system. Payors who invest in CCM today are building a future where chronic conditions are managed proactively, not reactively; where care is coordinated, not fragmented; and where member support is ongoing, not episodic. Kencor Health enables this future through scalable staffing, real-time data insight, and seamless operational execution, bringing the next generation of chronic care to life.
Ready to elevate your chronic care management program? Contact Kencor Health at support@kencorhealth.com or visit our website at www.kencorhealth.com to discover how we can help your organization improve member outcomes and achieve sustainable financial performance.
