For physician practices, the gap between patient needs and available clinical capacity keeps widening. Providers are responsible for managing increasingly complex chronic conditions including hypertension, diabetes, COPD, CHF, CKD, obesity, and depression, all while dealing with stagnant office visit reimbursements, staffing shortages, and rising administrative tasks.
Chronic Care Management (CCM) offers a structured way to support patients between visits, providing consistent monthly engagement that improves outcomes, enhances adherence, and builds patient trust. With CCM, practices gain a sustainable model for proactive care that reduces surprises, stabilizes patient health, and creates recurring revenue.
CCM Brings Stability to Patients Who Need It Most
Most chronic disease complications happen because of what occurs outside the clinic: missed medications, poor diet, confusion about instructions, worsening symptoms, or lack of follow-up. CCM introduces stability by ensuring every eligible patient receives meaningful touchpoints each month.
Care coordinators guide patients through symptom management, medication adherence, lifestyle changes, and problem-solving, giving providers much clearer visibility into patient needs. This predictable contact helps reduce blood pressure levels, stabilize diabetes control, improve COPD/CHF symptoms, and prevent avoidable deterioration.
CCM Helps Reduce Provider Workload Instead of Increasing It
With Kencor Health’s CCM model, providers don’t take on additional tasks. They gain a care team extension that handles:
- Monthly outreach and follow-ups
- Care plan updates
- SDoH screenings
- Medication assessments
- Documentation and time tracking
- Escalations to providers when needed
How Kencor Health Deploys and Operates CCM for Practices
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 Offers A Robust Care Management Platform
- Seamless bi-directional integration with EHR systems
- Real-time synchronization of medications, problems, vitals, and updates
- Unified care plan builder
- Automated documentation and time-tracking
- SDoH assessments and resource navigation
With Kencor Health’s dedicated staffing and turnkey program management, our team manages eligibility, patient identification, enrollment, monthly interactions, documentation, compliance, and reporting.
Financial Benefits: Strengthening Practice Stability
CCM becomes a dependable revenue stream through CPT 99490, 99439, 99491, and 99437.
With Kencor, practices gain:
- Recurring monthly revenue
- Improved cash flow
- Higher patient retention
- Better medication adherence
- Increased financial capacity for staffing and innovation
The Bottom Line Is: CCM Provides Better Care, Less Stress, Sustainable Operations
Ready to transform your practice with comprehensive chronic care management? Contact Kencor Health at support@kencorhealth.com or visit our website at www.kencorhealth.com to learn how we can help you deliver better patient outcomes while strengthening your practice’s financial health.
