Chronic Care Management
Coordinated Care for Complex Conditions
Managing multiple chronic conditions can feel overwhelming. Sterling Health Solutions's Chronic Care Management program provides the ongoing coordination, support, and clinical oversight you need to take control of your health — all covered by Medicare.
What is Chronic Care Management?
A Medicare program designed to help patients with multiple chronic conditions
Chronic Care Management (CCM) is a Medicare program created to provide ongoing care coordination for patients living with two or more chronic conditions that are expected to last at least 12 months. The program recognizes that managing complex health needs requires more than periodic office visits — it requires continuous, structured support between appointments.
At Sterling Health Solutions, our CCM program assigns you a dedicated care coordinator who serves as your health advocate. This coordinator works closely with your primary care physician and all of your specialists to ensure your care plan is comprehensive, up-to-date, and consistently followed. From medication reviews to appointment scheduling, from lab result tracking to health education, every aspect of your care is actively managed.
The goal of CCM is straightforward: keep you healthier, out of the hospital, and in control of your chronic conditions through proactive, coordinated care that bridges the gaps between office visits.
Who Is Eligible?
CCM is available to Medicare patients with two or more qualifying chronic conditions
To qualify for Chronic Care Management, a patient must have two or more chronic conditions that are expected to last 12 months or longer and place the patient at significant risk of death, acute exacerbation, or functional decline. Common qualifying conditions include:
This is not an exhaustive list. Many other chronic conditions qualify for CCM. Contact us to determine your eligibility.
What’s Included in CCM
Comprehensive care coordination services designed around your needs
Comprehensive Care Plan
We develop a detailed, personalized care plan that addresses all of your chronic conditions in a coordinated manner. This plan outlines your medications, treatment goals, specialists involved, lifestyle recommendations, and self-management strategies. It is reviewed and updated regularly as your health evolves.
Monthly Check-In Calls
Your dedicated care coordinator contacts you at least once per month to review your symptoms, medication adherence, and overall well-being. These conversations are an opportunity to address concerns, answer questions, and identify potential issues before they require emergency care.
Medication Management
Managing medications across multiple chronic conditions can be complex and overwhelming. Our team maintains a current medication list, watches for interactions, coordinates refills, and communicates with your prescribing physicians to ensure your regimen is safe and effective.
Specialist Coordination
When you see multiple specialists, communication gaps can lead to conflicting treatments or missed follow-ups. Our care coordinators serve as the central hub, ensuring all of your providers have access to the same information and are working toward aligned goals.
24/7 Care Line Access
Health concerns don't wait for office hours. As a CCM patient, you have around-the-clock access to a clinical care line. Whether you have a question about symptoms at midnight or need guidance on a medication issue over the weekend, support is always just a phone call away.
Preventive Health Guidance
Beyond managing your current conditions, we focus on prevention. Our team ensures you stay current on recommended screenings, immunizations, and preventive measures that can stop new conditions from developing or existing ones from progressing.
Medicare Coverage
Quality chronic care management that is accessible and affordable
Chronic Care Management is covered under Medicare Part B. For most Medicare beneficiaries, CCM services come with a minimal monthly copay — typically around $8 to $13 per month for standard CCM. Many patients with supplemental insurance or Medigap policies have this copay covered entirely, resulting in zero out-of-pocket cost.
Enrollment in CCM requires a one-time consent, which can be provided verbally or in writing. Our team walks you through the process and explains exactly what to expect. You may dis-enroll at any time, for any reason, with no penalty.
Our billing team verifies your insurance coverage before enrollment and handles all claims directly with Medicare. If you have questions about your specific coverage, call us at (214) 256-3300.
Benefits of Chronic Care Management
How CCM improves outcomes for patients with complex conditions
Better Health Outcomes
Patients enrolled in CCM programs experience measurably better outcomes. With consistent monitoring, proactive medication management, and regular care team contact, chronic conditions are better controlled and complications are less frequent.
Coordinated, Whole-Person Care
Instead of managing each condition in isolation, CCM takes a holistic approach. All of your providers are connected through a single care plan, reducing duplication, preventing conflicting treatments, and ensuring nothing falls through the cracks.
Reduced Hospitalizations
Research consistently shows that patients receiving chronic care management experience fewer emergency room visits and hospital admissions. By addressing issues proactively through regular check-ins, many health crises can be prevented entirely.
Patient Empowerment
CCM gives patients the education, tools, and support they need to take an active role in managing their health. Understanding your conditions, medications, and warning signs puts you in control and improves your confidence in self-management.
Patient Experiences
How chronic care management has made a difference
“Between my diabetes, high blood pressure, and arthritis, I was seeing four different doctors and nobody was talking to each other. My CCM coordinator at Sterling Health got everyone on the same page. My A1C has dropped a full point in six months.”
Margaret W.
CCM Patient, Irving
“The monthly check-in calls are a lifeline. My coordinator caught that I had been taking the wrong dose of one of my medications for weeks. That kind of attention to detail is what sets this program apart.”
Harold S.
CCM Patient, Garland
Start Managing Your Health Better
Enroll in our Chronic Care Management program and get a dedicated care coordinator who keeps you on track, connects your providers, and is just a phone call away. Covered by Medicare with little to no copay.