Care Management for Primary Care

For primary care specifically, four things separate a workable CCM platform from a demo:

• Automatic eligibility screening against your existing panel, so you aren’t building the list by hand.
• Time tracking that runs inside the work, capturing in-platform minutes automatically and allowing manual entry for calls, with month-end totals mapped to 99490 and 99439.
• An APCM path, because many practices can’t reliably log minutes and are better served by G0556–G0558 with no time requirement.
• Optional clinical staffing, since most primary care practices have no spare coordinator.

HealthArc does all four on one login, with the clinical pod option under your NPI.

For a clinic of one to ten providers the constraint is almost never features. It’s staffing and setup burden. The questions worth asking a vendor are whether there is any upfront device cost, whether the devices need patient Wi-Fi or an app, how many hours of staff training the launch takes, and whether the vendor can run the monitoring for you.

HealthArc ships cellular devices with no upfront cost, needs about four to eight hours of total staff onboarding, and can operate the programme end to end under your supervising provider’s name.

Count whether your team can reliably document minutes. CCM pays more per patient but requires 20 minutes of tracked clinical staff time a month. APCM pays a single monthly amount by risk tier (G0556, G0557, G0558) with no time-tracking requirement at all.

Practices that abandoned CCM because the minute-counting was unworkable are usually the best fit for APCM. A patient cannot be enrolled in both in the same calendar month, so the platform should flag the conflict at enrolment rather than at billing.

Yes, and FQHCs are among the strongest candidates because the panels carry high chronic-disease burden and the coordination work is already happening. Billing mechanics differ from a fee-for-service practice, so the programme design and the code selection need to be built around your specific payment structure.

We scope that during discovery rather than assuming a standard fee-for-service model.

More than most practices expect. Any Medicare patient with two or more chronic conditions expected to last at least twelve months qualifies for CCM, which in a typical primary care panel is a large minority of the Medicare population.

We run the analysis against your own panel by diagnosis code and payer mix before you sign anything, so the number you plan around is yours rather than an industry average. You can also model it yourself with the revenue calculator.

Not necessarily. Practices with an existing care coordinator often run the programme themselves on the platform. Those without one use our managed service, where a clinical pod handles enrolment, outreach and documentation under your supervising provider’s name and NPI.

Hybrid is the most common arrangement: your team keeps the patients it knows, and ours absorbs overflow and after-hours contact attempts.