elderly man sitting with cane receiving medicare chronic care management with home monitoring

Chronic Care Management

with In-Home Remote Physiological Monitoring

We are now expanding our continuity of care from our office to your home. Through remote physiological monitoring, our physicians are able to monitor your vital health data to better facilitate management of your chronic conditions.

Chronic Care coordination

Small changes in behavior can have a significant impact on your health. When you stay connected through our Priority Care program, your doctor has more key information to help facilitate positive outcomes in your care.

Benefits of Chronic Care Management

24/7 Care

Our expert medical professionals are always available to educate and guide you with your care plan. Experience the full-time support of your care team, even long after you’ve left the doctor’s office.

Decrease your healthcare costs

Through value-based reimbursement, we are able to deliver the best care to our patients at the lowest cost. In turn, patients receive a higher quality of care at a better value. Our increased care coordination provides the ability to scale effective interventions which will prevent many unnecessary costs.

Personal take-home health kit

Our platform uses modern technological advances to create a simple, easy-to-use system to help you better understand and manage your own care. We can help you experience the advantages of modern healthcare.

Family access

Enjoy peace of mind by keeping up with your health status and that of your loved ones. Here you will have access to the highest level of detail and communication for you and your loved ones in managing your family’s health.

Patient support and education

Chronic care management always includes regular checkups from your MedHelp provider. These checkups are strategically designed to empower you with the knowledge and understanding you need to better manage your chronic conditions.

Live life more fully.
Learn more about our chronic care management services.

Chronic Care Management with Home Monitoring FAQs

What is Remote Physiological Monitoring?

Remote Physiological Monitoring is the use of digital technologies to monitor and capture medical and other health data from patients and electronically transmit this information to your healthcare providers for assessment and, when necessary, recommendations and instructions. Remote Physiological Monitoring allows your providers to continue tracking healthcare data for you once you are discharged. It also encourages you to take more control of your health.

What are common patient data types collected with remote physiological monitoring?

Your providers can use remote physiological monitoring to collect a range of patient health data, including blood pressure, vital signs, weight, heart rate, blood sugar levels, and physical activity.

What are common examples of remote physiological monitoring devices?

We commonly use blood pressure monitors, weight scales, cardiac monitors, and blood glucose meters to remotely monitor patient health. Pulse oximeters will likely become more common due to the COVID-19 pandemic.

What are the benefits of using remote physiological monitoring?

Benefits of remote physiological monitoring include:

  • Keeping patients with multiple conditions healthy
  • Reducing the number of hospitalizations
  • Reducing readmissions
  • Reducing hospital lengths of stay
  • Reducing patient, provider, and overall healthcare costs
  • Permitting older and disabled individuals to remain at home longer and delay or avoid moving into skilled nursing facilities
How is remote patient monitoring different from telehealth?

Remote physiological monitoring is considered a specific subset of telehealth. You can use the phrase ‘telehealth’ to refer to remote physiological monitoring, but telehealth can also refer to many other types of remote healthcare services. Remote physiological monitoring is the use of a device for interaction between you and your provider. Read more about our telehealth services.

What types of services can be provided with Chronic Care Management?

There are a wide range of services that can be provided under chronic care management for Medicare beneficiaries with multiple chronic conditions. While the list below is not exhaustive, it provides examples of the types of services that we can provide:

  • Care management and transitional care management services
  • Communicating with the Medicare beneficiary in person, by phone, or electronically for care coordination
  • Community resource referral and linkage
  • Coordinating community and social support services
  • Disease self-management education and support
  • Health coaching
  • Health education, including health literacy
  • Interventions to reduce falls or risk factors for falls
  • Medication management
  • Preventive health counseling
  • Symptom management
What is an initiating visit?

Before we can offer Chronic Care Management services, there must be an initiating face-to-face visit with a Medicare qualified provider for new patients or patients who have not been seen within one year prior to the starting Chronic Care Management services. The initiating visit can be an annual wellness visit, an initial preventive physical exam, transitional care visit, or other qualifying evaluation and management visit. This visit is not part of Chronic Care Management services and is billed separately.

Who needs chronic care management services?

Chronic care management can benefit you if you have multiple chronic conditions that are expected to last a year or more. We help patients with conditions such as diabetes, high blood pressure, lupus, multiple sclerosis, and sleep apnea to understand their conditions and live successfully with them.

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