What Is Chronic Care Management?
Chronic Care Management (CCM) is a proactive, Medicare-approved service designed to support patients with two or more chronic conditions—such as diabetes, hypertension, COPD, arthritis, or heart disease. These individuals often require frequent communication, medication adjustments, and consistent engagement to prevent complications and maintain long-term health.
Through monthly check-ins by licensed clinical staff, CCM helps patients stay on track with their treatment plans. This includes reviewing symptoms, ensuring medication compliance, providing lifestyle coaching, and reinforcing preventative care—all between in-office visits.
Chronic care services reduce ER visits and hospitalizations while improving patient outcomes and satisfaction. For providers, CCM offers a powerful way to enhance care quality and generate ongoing revenue—without burdening internal staff or disrupting workflow.
Why OnPoint Partners with 24Our Care®
At OnPoint, we collaborate with 24Our Care® because of their trusted and proven ability to deliver Medicare care coordination services at scale. Their team of licensed U.S.-based clinicians provides Chronic Care Management (CCM), Remote Patient Monitoring (RPM), Behavioral Health Integration (BHI), and Annual Wellness Visits (AWV) in full compliance with CMS requirements.
By combining OnPoint’s consultative expertise with 24Our Care’s clinical infrastructure, we help practices implement a complete turnkey solution that improves patient care, drives engagement, and increases recurring revenue. There’s no added staffing, software, or disruption to your daily operations—just better care delivered efficiently and effectively.
This partnership ensures that our clients receive a service model that is scalable, compliant, and designed to reflect the high standards of their practice while delivering meaningful outcomes to patients.
Clinical Outcomes of Chronic Care Management
Chronic Care Management (CCM) services are proven to enhance patient outcomes across a wide range of clinical indicators. Multi-center research studies, Medicare claims analysis, and independent benchmarks have consistently shown that CCM participation leads to measurable improvements in condition control, preventive screenings, and reduced acute care usage.
Frequently Asked Questions
Chronic Care Management (CCM) for Medical Providers
What does 24Our Care® provide to help implement CCM in my practice?
How is the service billed? Do I need to handle billing internally?
Who communicates with my patients?
Do I have to install any new software?
What types of practices benefit from outsourcing CCM?
What happens if a patient opts out or discontinues participation?
What are the time and supervision requirements?
What compliance standards are followed?
How much training is required for my staff?
How long does it take to launch the program?
Can we review patient outcomes and program performance?
Can I still bill for in-office visits and other services?
Still have questions?
If you're considering adding a CCM program or working with 24Our Care®, click below to email us directly. We’ll respond promptly and connect you with the right team.
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