One care-management program CMPM can stand behind in an audit: the chronic and principal care management your clinicians already run, moved to a CoachCare care team inside eClinicalWorks with every billed month documented in the chart, and remote monitoring added for primary care, endocrinology and cardiology patients, billed under your own NPIs
Medicare is changing what it pays primary care for. Four shifts are under way at once, and each one lands in the same place: the weeks between a patient’s visits. For a group whose Medicare patients carry hypertension, diabetes and heart disease together, across primary care and its own specialty practices, those weeks decide how the year goes.
Consolidated Medical Practices of Memphis began in 2008, when six small internal medicine practices joined forces to stay independent, and it is still physician-owned. Today it runs 22 locations with nearly 40 physicians and more than 50 nurse practitioners, physician assistants and other clinicians, in primary care and eight specialties, on one eClinicalWorks system. Its traditional-Medicare primary care patients average 75 years old; at least three in four have hypertension and one in four has diabetes. In 2026 its clinicians bill inside an Enhanced-track Medicare Shared Savings Program ACO, and the group already runs chronic and principal care management between visits across its clinicians.
An older Medicare panel, average age 75, in which hypertension and high cholesterol are the norm and diabetes, heart disease and kidney disease are common.
At least 74% of the group’s traditional-Medicare primary care patients carry a hypertension diagnosis. Home readings catch what one office reading misses and let the care team adjust medication month to month instead of at the next visit.
25% of the group’s traditional-Medicare patients have diabetes and 17% chronic kidney disease, usually alongside hypertension. Two or more chronic conditions is the patient chronic care management was written for.
31% have ischemic heart disease, 16% atrial fibrillation, 11% heart failure and 10% COPD. Two cardiology practices sit inside the group; daily weight and blood pressure fill in the months between visits.
Each step below added offices, clinicians or capability. Click through the years. The next step puts the care management CMPM already runs inside the chart, documented month by month, and adds daily readings for the patients who need them.
Each part of CMPM touches a patient at one moment: an office visit, a wellness visit, an endocrinology or cardiology appointment, a hospital stay. A remote care service line connects them, so a patient who leaves one visit is still being watched until the next one. Select any part of the practice to see what changes.
CMPM’s clinicians set the protocols and own every clinical decision. CoachCare staffs and runs the program. Everything runs through the eClinicalWorks system every location already uses, from the first flag on a patient’s chart to the claim at month end.
The program starts with the panel, not a referral pad. eClinicalWorks already holds the diagnoses, vitals, labs and medications. Patients with uncontrolled hypertension, diabetes, kidney disease or several chronic conditions are flagged using criteria the group’s clinicians set, so the right patients surface at a chronic-care visit, at an annual wellness visit, or on an outreach list.
Example criteria. The group’s clinicians set and own the flag logic for each condition.
Patients enter at an office visit, at a chronic-care or annual wellness visit, or after a hospital stay. Either way they land in the same monthly loop: office visits, care management and physiologic monitoring, each one informing the next.
BP 162/96 on three agents and an A1c above 9. The clinician places the remote care order during the chronic-care visit, or at the annual wellness visit.
Cellular cuff and glucometer at home, a welcome call by phone, and how to take a reading that counts.
99453Home averages drive medication changes month to month; the CCM call covers the other conditions.
99454 · 99457 · 99490Office visits ↻ care management ↻ physiologic monitoring.
Flagged in eClinicalWorks when the discharge notice arrives. Devices ordered to the home.
Contact within two business days, medication reconciliation, an office visit in 7–14 days.
TCM 99495 · 99496Readings start right away. The short-month device code covers the first partial month.
99453 · 99445 · 99490Office visits ↻ care management ↻ physiologic monitoring.
The clinician orders from the chart, or a CoachCare enrollment specialist working in the office enrolls the patient during the visit.
Cellular devices arrive ready to use. No Wi-Fi, no smartphone and no home internet needed, and nothing for the patient to pair.
The patient’s assigned care manager walks through the device, the routine, and who to call. The routine is set to fit the patient’s day.
Readings reviewed, outreach logged, care plan updated, escalations routed. Repeats every month.
From the enrollment flag in eClinicalWorks to the first billable day of service. Enrollment status is visible in the chart the whole way through, at every location.
Readings that settle are logged in the chart and visible to the clinician without paging anyone.
Out-of-range readings get a retake and symptom check first. A confirmed trend goes to the clinician or nurse each practice designates, in eClinicalWorks, with the readings and a recommended next step attached.
Chest pain, new shortness of breath or stroke signs reported on a call: the care team calls 911 with the patient on the line, then notifies the office. A critical reading on its own goes to the office. This cannot be configured away.
CMPM’s patients are already enrolled, and their consent is recorded to the CMPM clinician who bills for them, so a change in who staffs the program does not start it over. Each patient’s consent is still checked in the inventory. The modeled move runs in six monthly waves of about 333 patients, practice by practice, while new enrollment runs alongside.
A month that does not meet its code is not billed. Remote monitoring adds its own requirements: 16 reading days for 99454 and a real-time conversation with the patient or caregiver for 99457.
At month end, three things come out of the program: clean claims in eClinicalWorks, an operational report for the practice’s leadership, and a clinical outcomes report for the clinicians.
CoachCare is the only care-management application integrated with eClinicalWorks that creates claims automatically. No one builds a claim by hand, patient by patient, month by month.
A monthly scorecard for the practice. Sample below at the modeled month-12 census.
A 24-month forecast for one CMPM care-management program: the patients enrolled today moved to a CoachCare care team, new chronic and principal care management, and remote monitoring across primary care, endocrinology and cardiology, priced at Tennessee’s CY2026 Medicare rates with every patient priced at the Medicare amount, alongside what the program does for patients and for the people who run it.
Two chronic-care visits a year leave 363 days with no data. RPM bills only when a patient takes readings on at least 16 days in a month, so an enrolled patient gives the care team at least 192 days of readings a year.
Hypertension is the most common condition on the group’s panel and the one home monitoring moves fastest. Home averages give the care team a monthly reason to adjust medication, and the documented result is the home number, not one rushed office reading.
Cardiac Solutions, a physician-owned cardiology practice with three West Phoenix offices, put 2,738 patients on CoachCare RPM with home blood-pressure monitoring.
CMPM’s clinicians take part in an Enhanced-track Medicare Shared Savings Program ACO, which is scored on a fixed set of quality measures. Most of them depend on work this program does every month. Select a measure to see how.
Monitoring the panel every day tells the practice who needs to be seen now, not only who is next on the schedule. Patients surface from their home data, not only when they come in sicker.
Thirteen of the group’s clinicians already bill transitional care after hospital stays. The next 30 days decide whether a patient comes back, and remote monitoring and chronic care management carry the patient past them.
Flagged in eClinicalWorks for post-discharge monitoring.
A call within two business days and medication reconciliation.
Readings start right away. 99445 bills the short first month.
Monthly RPM with CCM while it adds value.
Daily weight and BP from day two, three touches inside two weeks, a cardiology referral when the trend returns.
Oxygen saturation and symptoms after an exacerbation, with a quick visit before a return trip to the emergency department.
Glucose and BP while medications change after a stay, and a fluid check for patients with CKD.
Patients who carry hypertension or diabetes into recovery stay on their readings until the follow-up visit.
Every code the service line can bill, at CY2026 Medicare rates for Tennessee. Build a patient-month to see what one patient is worth.
CY2026 Medicare Physician Fee Schedule, non-facility, Tennessee locality 35 (Palmetto GBA, MAC 10312). Only one device code (99454 or 99445), one first-tier management code (99457 or 99470) and, in this builder, one care-management program (CCM, PCM or APCM) bill for a patient in a given month. About 48% of Medicare beneficiaries in Shelby County are in Medicare Advantage. Those plans must pay at no less than the Medicare rate, a floor; individual contracts set their own terms for the care-management code families, and the forecast prices every patient at the Medicare amount.
CMPM can move the program it runs today and stop there, or move it and grow it into remote monitoring and new care management across primary care, endocrinology and cardiology. Either way the contribution margin is positive. Select a deployment to redraw the charts.
| Full program | Year 1 | Year 2 | 24 months |
|---|---|---|---|
| Unique patients, end of period | 3,251 | 4,457 | 4,457 |
| Contribution margin | $1,121,982 | $2,359,167 | $3,481,149 |
| Contribution margin is positive from month 1. No shared-savings dollars are in these figures. | |||
Change the assumptions and the 24-month forecast recalculates. Start from a deployment or move the sliders yourself. The number of patients enrolled today is the first thing to plug in. New enrollment is held to the same staffing plan, no more than 1,500 new patients a year, so the number of referring clinicians moves the answer less than the number enrolled today: from the 29 physicians alone to 85 clinicians, 24-month contribution margin runs from $3.39M to $3.49M; from 900 to 3,000 patients moved, $2.68M to $4.21M.
CoachCare hires, trains and manages the care managers who run the program, at a caseload of 165 patients each. Drag the slider to see the team grow with the census.
The group’s physicians, nurse practitioners, physician assistants and medical assistants keep doing clinical work. The monitoring, outreach and paperwork belong to CoachCare.
Monitoring, outreach and documentation for the newly enrolled patients over 24 months, on CoachCare’s payroll, before the hours spent on the patients moved from today’s program.
Hired, trained and managed by CoachCare. CMPM would otherwise need to recruit and keep them.
The enrollment specialists working in the practices and device logistics are CoachCare’s expense.
Direct integration with the eClinicalWorks system CMPM already runs, using its built-in workflows. Clinicians never leave the chart, and the evidence behind every billed month (time logs, care plans, vitals and the monthly care summary) is attached to the patient’s chart every month, where a reviewer would look for it.
eClinicalWorks integration overviewThe staff, protocols and eClinicalWorks workflow built for care management and remote monitoring can take on the next programs the group’s panel qualifies for, without a second hiring plan.
APCM pays a monthly amount per patient in place of CCM, tiered by complexity, to a practice that runs the whole panel. CMPM can bill it today, and its Shared Savings Program participation fits the accountable-care model APCM was built around. Moving patients from CCM to APCM is a program decision to make together.
About one in six traditional-Medicare patients carries depression, and the group screened about ~2,600 for it in CY2024. Behavioral health integration fits the same care-manager calls and the same chart.
Thirteen of the group’s clinicians already bill transitional care. The same care team can make the two-business-day call after every discharge, so more of them qualify, billed by the group.
Six reasons this partnership fits CMPM specifically, not remote care in general.
Chronic and principal care management already run across CMPM’s clinicians, alongside annual wellness visits, transitional care and endocrinology and cardiology under one roof. CoachCare moves that program into the chart, documents every month of it, and adds remote monitoring where it helps.
Built on eClinicalWorks’ own workflows. Consent, care plans, time logs, readings and claims live in the chart, so the record behind every billed month is where a reviewer would look for it, at every location.
CoachCare’s care managers carry the caseload at 165 patients each. Enrollment, devices, business-hours alert triage and billing preparation are on CoachCare’s payroll, with no capital outlay.
CMPM’s clinicians set the protocols, sign the care plans and make every clinical decision. Claims go out under the group’s own billing entity and NPIs, and the revenue stays with a physician-owned group that has stayed independent since 2008.
The group’s traditional-Medicare patients average 75. Cellular devices need no home internet, no smartphone and nothing to pair, and outreach runs by phone, so no patient has to learn an app.
A 29.1 mmHg drop in Stage 2 hypertension across 2,738 patients at Cardiac Solutions in West Phoenix (case study), half the 30-day readmission rate across 26,689 patients at the same practice (case study), and zero readmissions among 450 advanced heart-failure patients at Iowa Heart (case study).
The ask: a working session with CMPM’s leadership to confirm how many patients are enrolled today and under which codes, review a month of the program’s documentation together, scope the eClinicalWorks integration, and choose the practices whose patients move first.
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