$50–$120 per patient per month in new Medicare revenue. Without adding staff.
CareAtlas runs RPM, CCM, TCM, and APCM end-to-end for primary care and specialty practices — as CareAtlas Complete (we run everything, you refer), or as CareAtlas Extend (we augment your existing care-management team). Your practice stays provider of record. Your patients get the monthly contact their conditions actually require. Revenue varies by program mix, volume, and payer. Not a guarantee of income.
The forces pressing in on independent and group practices
Panel size keeps growing, the staff to manage it doesn't, and the Medicare revenue sitting in your chart keeps going uncaptured.
You stay the provider of record — we run behind you.
A 40,000+ primary care physician shortage is compounding nationally. For an independent or group practice, panel growth outpaces hiring. The patients whose chronic conditions need monthly contact aren't getting it — not because your physicians don't want to deliver it, but because the operational capacity to run a credible CCM or APCM program simply isn't in the practice's cost structure.
The Medicare programs that pay for this work exist. Most practices don't run them.
Only 4% of eligible Medicare patients are enrolled in CCM nationally. The 2026 PFS raised CCM reimbursement by ~10% — and APCM pays $16, $54, or $117 patient/mo with no time-tracking requirement. The programs pay. The operational lift of running them doesn't pencil for most practices
Most "care management" vendors are a staffing firm in a trench coat.
You've probably seen the pitch. A vendor brings untrained operators, a generic script, and a "monthly check-in" that patients learn to ignore. Churn is high. Engagement is low. Your physicians stop trusting the program. CareAtlas is structured differently — licensed care navigators, a relationship-based model, and a platform your clinicians can actually see into.
The practice stays provider of record. The patient relationship stays yours.
Outsourcing care management should never mean outsourcing the patient relationship. In CareAtlas Complete for practices, your physician remains provider of record. In CareAtlas Extend, your existing care-management team stays in the lead and we augment behind them. The PCP relationship — which is the long-term revenue relationship — stays with your practice.
We have a model that fits.
Every organization is different. CareAtlas offers three models so you get exactly the level of support you need — from full-service to platform-only.
CareAtlas Complete
Full-service care coordination. We provide the navigators, technology, devices, enrollment, billing, and care delivery — end to end. For hospitals, CareAtlas serves as provider of record — no upfront investment required. For practices and community health centers, revenue consistently exceeds program costs.
CareAtlas Extend
Already have some care coordination staff? We augment your team with the HealthQuilt platform, device logistics, and overflow navigator support — filling gaps without replacing what works.
CareAtlas Connect
Platform-only access to HealthQuilt — our AI-assisted care coordination software, EHR integration, analytics, and compliance tools. You bring the team. We bring the technology.
Four programs.
One operating partner.
Each of these programs runs inside HealthQuilt and delivers both clinical impact and Medicare revenue. Together they form an integrated care-management program for your Medicare population.
Remote Patient Monitoring
RPM: Daily visibility into patient health
Cellular-connected devices ship directly to patients — blood pressure cuffs, glucose monitors, pulse oximeters, scales. No WiFi. No smartphone. No patient app. Daily readings are monitored by dedicated care navigators with AI-assisted alerts that catch deterioration before it becomes an ER visit.
Chronic Care Management
CCM: Consistent care between appointments
Monthly navigator check-ins, personalized care plans, medication management, and social determinant screening — all documented and billed under 99490/99491. Only about 18% of eligible Medicare discharges receive a TCM bill, even though roughly 52% of unbilled eligible discharges already had a qualifying visit within 14 days. CareAtlas helps close that gap.
Transitional Care Management
TCM: The critical 30 days after discharge
Navigator outreach within 48 hours of discharge. Medication reconciliation. Follow-up scheduling. 30 days of transition support during the window when patients are most vulnerable — and when the vast majority of billable TCM episodes go uncaptured. Only ~9% of eligible Medicare discharges result in a TCM bill, and among those unbilled, over half already had a qualifying office visit within 14 days — revenue left on the table.
Advanced Primary Care Management
APCM: The newest Medicare revenue pathway
APCM reimburses across three risk-stratified tiers — $16/mo (Level 1), $54/mo (Level 2), and $117/mo (Level 3) — with no time-tracking requirements. For a panel of 200 patients at Level 2, that's ~$129K/year in recurring revenue, billable alongside RPM.
