Ask About Our
Chronic Care Management (CCM) Program

Extra support between visits for patients living with two or more long‑term health conditions—so you can stay on track, prevent complications, and feel your best.

Program Coordinators
Stephanie Wilson, CMA Shaina Gandini, RMA

What is Chronic Care Management (CCM)?

CCM is a dedicated program for patients with two or more long‑term conditions (such as diabetes, heart disease, or asthma). It provides support and coordination beyond your regular doctor visits—including scheduled phone check‑ins—so your care team can monitor your conditions, help manage medications, and make sure you’re following your treatment plan.

What’s the goal of CCM?

The goal is to improve your overall health and prevent complications by staying proactive about your chronic illnesses.

Key benefits

• Focus on multiple conditions: Designed for people with two or more ongoing health issues that need continuous care.

• Regular communication: A dedicated care coordinator will call you monthly or bi‑monthly to discuss your health, medications, and any concerns. Our care coordinators include our medical assistants, nurse practitioners, and our physician assistant. 

• Improved coordination: We help keep all your providers on the same page and coordinate information from your specialists. CCM coordinators can even schedule urgent appointments with your provider and assist with medication refills when needed.

Does it cost anything to participate?

Chronic Care Management is covered by Medicare (80% covered, 20% coinsurance) and many other plans. There may be some out‑of‑pocket costs for patients. However, CCM may save you money through fewer ER visits, better medication control, and fewer hospitalizations through better access to care.