Chronic Care Management (CCM) is a comprehensive healthcare approach designed to enhance the quality of life for individuals dealing with chronic health conditions. This proactive and patient-centered model focuses on managing and coordinating care for those with long-term health issues, such as diabetes, heart disease, arthritis, and neurological disorders. We meet with patients on an ongoing basis based on their specific conditions and needs.
Patients with two or more chronic conditions
Our physician group has contracts with the main payers in NY and NJ, and we focus on virtual consultations alongside traditional in-person visits. We are not a replacement for a patient’s PCP, but rather a specialist group that can assist in between doctor’s visits.
We perform an initial telehealth assessment to determine the best care plan for the patient’s needs. From there, we have a schedule of ongoing visits that align with that patient’s care plan. We are available as a resource to patients to call us when they need us, and we can also assist with DME allocation, Rx refills, care coordination like transportation to a doctor’s office, and specialist referrals.