Chronic Care Management (CCM) is a Medicare-supported program designed to keep patients with multiple chronic conditions connected to their care team every single month — not just when they come in.
Book My Free 20-Minute Eligibility Review → No commitment. No pitch. Just a clear look at what's possible for your clinic.The Gap No One Talks About
Most clinics do great work inside the exam room. But for patients managing diabetes, heart disease, COPD, or other chronic conditions — that 15-minute visit is only a small slice of their month. The rest of it? They're often on their own.
A patient leaves with instructions but there's no structured touchpoint until their next appointment — sometimes 90 days away. A lot can go wrong in 90 days.
When symptoms flare up, patients either wait it out, go to urgent care, or end up in the ER — all avoidable with a simple monthly care coordination call.
Most clinics have heard of CCM but either haven't started, tried and stopped, or have it running in a way that barely scratches what it could do.
Plain-Language Explanation
CCM is a Medicare program that funds proactive, monthly care support for patients managing two or more chronic conditions. Think of it as a structured check-in system that keeps your patients connected between visits.
Under CCM, your clinic's care team spends at least 20 minutes per month providing non-face-to-face care coordination for eligible patients — medication reviews, care plan updates, referral coordination, and simply being reachable. Medicare reimburses for this time. But more importantly, your patients genuinely benefit from it.
The Honest Truth
It's not that clinics don't care. It's that CCM without the right structure feels like more work on an already stretched team.
How Provider Care Consultants Helps
We work directly with your clinic to build a CCM program that fits your workflow — without adding headcount or disrupting your team.
We handle documentation templates, patient outreach workflows, and compliance from day one.
No new hires needed. We work with your current staff to integrate CCM naturally.
Every piece of this is built around genuinely improving follow-through for your highest-need patients.
Want to run it yourself with guidance, or want us to manage it? We offer both paths.
Is This for You?
CCM isn't for every clinic — but if you see Medicare patients regularly and treat chronic conditions, there's a very good chance this fits.
Not sure if you qualify? That's exactly what the free 20-minute review is for.
Simple Next Steps
Three steps. No pressure. No obligation at any stage.
A quick 20-minute call with Kambry to look at your patient population and see whether CCM is a fit.
We walk through what a CCM program would look like for your clinic — patient volume, workflow fit, and timelines.
If it makes sense to move forward, we do a deeper session with your clinical or admin team.
Book a free 20-minute eligibility review with Kambry. No fluff, no pressure — just a real look at your patient panel.
Claim My Free Eligibility Review →Schedule Your Call
Pick a time that works for you. Kambry will personally review your clinic's setup and give you a clear, honest assessment.
Who You're Talking To
Kambry works directly with clinic teams to assess, implement, and manage Chronic Care Management programs that actually stick. No hand-off to a junior rep, no generic pitch — just a real conversation about your patients, your team, and whether CCM makes sense for your practice.
Common Questions
Still on the fence? That's what the free call is for.
20 minutes with Kambry. No commitment. We'll tell you honestly whether CCM is worth pursuing — and what it would take.
Yes, Let's Take a Look →