Empowering healthcare organizations with integrated virtual care solutions that improve care coordination, reduce total cost of care, and drive success in value-based care.
Principal Care Management (PCM) programs support patients with one serious chronic condition—such as congestive heart failure, COPD or cancer—requiring intensive management. Providers benefit from more targeted care, while patients receive highly personalized support. PCM can enhance patient engagement, improve care coordination and help meet quality metrics.
Care managers contact patients each month to assess symptoms, progress and barriers
Establish and monitor SMART goals tailored to the patient’s primary condition
Optimize therapy, manage side effects and deprescribe inappropriate medications.
Identify social determinants of health that affect the condition and connect patients to community resources
Data integration across EHRs, HIEs and remote devices enables holistic views of patient health
Streamlined workflows assign appropriate CPT codes and maintain audit trails
Regular touchpoints empower patients to manage their condition
Personalized plans help meet disease‑specific benchmarks (e.g., heart failure readmissions).
PCM creates new reimbursement opportunities while supporting value‑based goals
Integration with CCM, RPM and TCM ensures continuity across the care continuum.
Our CCM solution is powered by board‑certified pharmacists who specialize in chronic disease and medication management. We leverage AI‑driven telehealth tools to monitor adherence, predict risks and provide real‑time interventions. By integrating with APCM, RPM and TCM, we ensure patients receive comprehensive, coordinated care while providers benefit from optimized workflows and higher quality performance.