Prepared for Alabama Medical Group · 2026 Strategy Review · Confidential — not for distribution
Remote Care Service Line Optimization · Prepared for Alabama Medical Group

Turn the Panel You Already Manage Into a Profit-Generating Service Line.

How Mobile's largest independent multi-specialty group converts the Medicare panel it already manages — hypertension, type 2 diabetes, heart failure, CKD, and COPD — into recurring remote-care revenue without adding a single hire. Powered by CoachCare.

$0
24-Month Net Reimbursement
$0
24-Month Practice Margin
0
Hospitalizations Avoided
0
Unique Patients in Active Remote Care at Month 24

Two counts, two different jobs. The headline is 2,491 deduped unique patients at month 24; the enrollment chart and the calculator show 3,791 active program enrollments, because a patient on both RPM and CCM is one patient but two enrollments.

Independent for 80 Years · Built to Stay That Way

2026 Starts From a Position of Strength

This is not a rescue story. Alabama Medical Group enters 2026 as it has operated since 1946 — physician-owned, multi-specialty, and independent. The strategic question is how to monetize the panel the group already manages, so the next 80 years are funded by the practice's own recurring revenue rather than by a buyer's balance sheet.

★ Verified

80 Years Independent

Founded 1946 — the largest independently owned, multi-specialty medical clinic in Mobile, Alabama, celebrating 80 years in 2026.

★ Verified

MSSP Enhanced-Track Participant

Alabama Medical Group PC appears on the CMS PY2026 ACO participant file for ACO A4894 — the Enhanced track, where the practice shares in two-sided savings its own chronic-care performance helps generate.

✓ In place

The Primary-Care Engine

11 internal-medicine physicians anchoring a 38-provider roster across internal medicine, family medicine, infectious disease, neurology, and rheumatology — with in-house lab, accredited imaging, and a walk-in clinic.

✓ In place

Veradigm EMR + Patient Portal

A Veradigm-family EMR with the FollowMyHealth patient portal already live — the digital front door a remote-care program plugs into.

One structural fact completes the picture: no remote patient monitoring, chronic care management, or principal care management program is marketed anywhere on the practice's public website today. The panel, the providers, the EMR, and the shared-savings contract are all in place — the missing piece is the service line itself.

The 2026 Window

Why This Panel, Why This Year

Three forces converge on an independent internal-medicine group in 2026: richer remote-care billing, mounting quality-reporting stakes, and consolidation pressure that makes practice-owned recurring revenue a strategic asset.

Live Now
CY2026

Short-Window RPM Is Now Billable

New CPT codes 99445 (2–15-day device supply) and 99470 (first 10 minutes of management) remove the 16-day floor that previously blocked episodic monitoring — so post-discharge and titration windows across the chronic panel are cleanly billable alongside the standard monthly RPM stack.

Compounding
Quality

MIPS & Shared-Savings Stakes

The same documented, between-visit touches that generate care-management revenue also move the measures Medicare grades primary care on — blood-pressure control, A1c control, follow-up after discharge. One program feeds both the fee-for-service ledger and the ACO's quality and cost performance.

Strategic
Independence

Recurring Revenue Is the Alternative

As regional systems consolidate physician practices, the durable defense is economic: diversified, recurring, practice-owned revenue from the panel the group already manages. A remote-care service line is that revenue — built on existing patients, staffed by CoachCare, owned by the practice.

Hypertension
Type 2 Diabetes
Heart Failure
Chronic Kidney Disease
COPD
The Operating Model

One Panel, One Coordinated Program

This is a named, governed service line with its own P&L and scorecard, not a point solution bolted onto one diagnosis. It follows the multi-chronic Medicare patient the practice already knows, on the EMR the practice already uses.

The Workhorse Stack — RPM + CCM
  • RPM Device-based physiologic monitoring (blood pressure, glucose, weight, pulse ox) for the hypertension, diabetes, and heart-failure cohorts — the continuous early-warning and titration layer between visits.
  • CCM Multi-condition chronic care management for the majority of Medicare patients carrying two or more chronic conditions — the monthly longitudinal wrapper for the whole panel.
  • TCM Structured 30-day transitional care management at every hospital discharge — the billable bridge back to the practice that also protects the ACO's readmission performance.
The Engine, the Staffing, and What Is Deliberately Off
  • Engine Enrollment outreach, cellular devices, 24/7 alert triage, nurse follow-up, documentation, and billing-ready claims — operated by CoachCare, governed by Alabama Medical Group physicians.
  • Staffing An on-site enrollment specialist recruited, employed, and paid by CoachCare works the panel at the practice — CoachCare's expense, embedded value, never deducted from practice margin.
  • Not PCM Principal Care Management is written for the patient whose care genuinely centers on a single dominant condition. A primary-care panel's care management is comprehensive across conditions, so CCM is the fitting code and PCM is not — PCM is switched off and carries zero dollars anywhere on this page.
The ownership rule: this is the practice's service line — its patients, its protocols, its revenue. CoachCare is the practice-owned engine underneath it, and it is complementary to any care-coordination tooling the group's ACO relationship may already provide: population-level analytics tell you who needs attention; this program is the staffed, device-connected, billable layer that actually touches the patient every month.

The CY2026 Billing Stack

ServiceCodes~CY2026 MagnitudeUse Across the Panel
Chronic Care Management99490 · 99439~$60 + ~$47 add'lThe longitudinal wrapper — 2+ chronic conditions
RPM setup & device supply99453 · 99454 · 99445 (new)~$20 setup · ~$52/moHTN, diabetes, HF cohorts; 99445 unlocks 2–15-day windows
RPM treatment management99457 · 99458 · 99470 (new)~$52 + ~$41 add'lMonthly review, titration, escalation
Transitional Care Management99495 · 99496~$200 / ~$280Every discharge back to the practice

The Value Analysis below uses MAC-locality rates auto-resolved for ZIP 36608 (carrier 10112, locality 00 — Alabama).

Off the stack, and off every figure: PCM (99426 · 99427) — a single-dominant-condition code that does not fit a comprehensive primary-care panel, where CCM is the right code. APCM (G0556–G0558) — named later on this page as a build-toward target only, with zero dollars attached.

Four Ways the Same Program Pays

One Service Line, Four Value Layers

The same infrastructure — enrollment, devices, alerts, follow-up, documentation, billing — compounds across every layer of value an independent internal-medicine group cares about.

1 · Recurring Revenue, Zero New Headcount
$4,811,041 in modeled 24-month net reimbursement — $2,053,752 of it practice margin — from the panel already on the schedule. Enrollment, monitoring, and documentation are CoachCare's work; the on-site enrollment specialist is staffed at CoachCare's expense. The practice adds programs, not payroll.
2 · MIPS & Quality Defense
Documented monthly touches move the measures. Blood-pressure control, A1c control, medication reconciliation, timely follow-up — the chronic-care measures that determine MIPS scoring and payment adjustments are the same behaviors the service line performs and documents every month, patient by patient.
3 · ACO Shared-Savings Contribution
Enhanced-track economics reward exactly this program. As a verified PY2026 participant in MSSP ACO A4894 (Enhanced track), the practice shares in savings driven by avoided utilization — and the model here projects ~186 avoided hospitalizations over 24 months, roughly $2.8M in acute-care cost that never gets spent. The fee-for-service revenue above is earned on top of, not instead of, that contribution.
4 · Independence Preservation
Recurring revenue is a strategic moat. After 80 years of independent operation, the strongest answer to consolidation pressure is a diversified income statement: a subscription-like care-management revenue stream that grows with the panel and is owned entirely by the practice, with no buyer, employer, or equity partner required.
In the System You Already Use

Built Into the Veradigm Workflow

Alabama Medical Group runs on a Veradigm-family EMR with the FollowMyHealth patient portal — an environment CoachCare integrates with directly. Enrollment triggers, patient health history, monitored vitals, care documentation, and billing-ready claims move between the platform and the chart, so clinicians work where they already work.

Veradigm The practice's EMR + portal One chart per patient Orders & flags Vitals & documents FollowMyHealth portal Billing workflow CoachCare Remote care platform Cellular devices 24/7 monitoring Health coaches Enrollment team Billing engine FROM THE PRACTICE Enrollment flags & referrals Patient health history BACK TO THE PRACTICE Monitored vitals & alert dispositions Care summary & compliance documentation Real-time enrollment status Claims — billing-ready, every patient, every month Clinicians stay in the chart they already use — the program lives alongside it

1,000+

successful program implementations across EMR environments — including the Veradigm family the practice runs today.

Confirmed in contracting

the specific Veradigm product configuration is validated during implementation planning, with integration setup scoped before launch — no surprises after signature.

A program lasts when it is easy on the people who use it. Keeping clinicians in the chart they already know, and patients on devices that work out of the box, is what EMR integration is for.

CoachCare Value Analysis · Modeled for Alabama Medical Group

The Value Analysis

A 24-month forecast for the RPM + CCM stack: an estimated 8,500-patient Medicare panel, 38 referring providers plus one CoachCare-funded on-site enrollment specialist, MAC-locality rates for ZIP 36608, Veradigm integration. PCM is off — a comprehensive primary-care panel is CCM territory, not single-dominant-condition territory. The ACO shared-savings contribution is not in these numbers, and APCM is named only as a build-toward target with zero dollars attached.

Active Program Enrollments by Program

Monthly active program enrollments (services, not patients) · physician referrals (5/provider/mo, 70% acceptance) + 1 on-site enrollment specialist (80/mo) + telephonic outreach, net of discharges. RPM saturates at 1,934 in month 20; CCM is still climbing at month 24 (1,857 against a 1,913 ceiling), so total enrollments are still growing when the forecast ends.

Monthly Economics — Revenue, Fees, Margin

Net reimbursement (after denials, coinsurance bad debt) vs. CoachCare fees; month 1 absorbs one-time setup, and margin is positive from month 2 onward

24-Month Net Reimbursement Mix

$4.8M total across the RPM + CCM stack — close to an even split on revenue, with CCM carrying the larger share of practice margin, exactly what a multi-chronic primary-care panel should produce

The Financial Summary

ProgramNet reimbursementCoachCare feesPractice margin
RPM — devices, data & management$2,460,106$1,448,099$1,012,007
CCM — chronic care management$2,350,935$1,203,670$1,147,265
Implementation, Veradigm integration & outreach—$105,520−$105,520
24-month total$4,811,041$2,757,289$2,053,752
Includes an on-site enrollment specialist staffed at CoachCare's expense — embedded value, never billed to the practice and never deducted from practice margin.

24-month practice margin: 42.7% of net reimbursement (Year 1 41.8%, Year 2 43.0%).

Year 1 is $501,995 of practice margin on $1,200,620 of net reimbursement (41.8%); Year 2 is $1,551,758 on $3,610,422 (43.0%). Month 1 is −$2,340 as the one-time setup lands ahead of the ramp, and monthly margin is positive from month 2 onward — there is no negative-margin quarter.

Full model available as a companion workbook.

Scenario Explorer — Build Your Own Forecast

Adjust the assumptions and watch the 24-month forecast recompute live.
24-mo net reimbursement
$4.81M
24-mo practice margin
$2.05M
Program enrollments at month 24
3,791
Hospitalizations avoided
~186
99,327

Billed Claims / Units

Recurring, subscription-like professional-fee volume over 24 months.

292,173

Physiologic Readings

A continuous clinical picture of the HTN, diabetes, HF, CKD, and COPD panels between visits.

~186

Hospitalizations Avoided

≈ $2.8M in avoided acute cost at $15K per admission — utilization relief the ACO's shared-savings math rewards.

21.0

FTE-Years Absorbed

≈ 43,633 care-team hours of monitoring, outreach, and documentation handled by the service line — not by practice staff.

Read the Plateau Correctly

Only One Curve Reaches Its Ceiling Inside 24 Months

RPM fills its eligible pool and flattens at 1,934 enrollments in month 20. CCM does not: at month 24 it stands at 1,857 against a ceiling of 1,913, still climbing. So this forecast ends mid-growth rather than on a plateau — unique patients go from 1,466 at month 12 to 2,491 at month 24, and month 25 would still be a larger number. With eligibility at 65% (RPM) and 75% (CCM) of an 8,500-patient panel, the eligible pool is deep enough that outreach pace, not the ceiling, sets the curve through most of Year 2.

ProgramEnrollment CeilingHow It's DefinedSaturates
RPM1,9348,500 × 65% eligible × 35% acceptanceMonth 20
CCM1,9138,500 × 75% eligible × 30% acceptanceNot inside 24 mo
At month 243,791Active program enrollments (RPM 1,934 + CCM 1,857) = 2,491 unique patients—

Eligibility is set for an adult primary-care Medicare panel; acceptance is deliberately conservative. Every point of eligibility or acceptance the practice's real chart data supports beyond these raises the ceiling — and the forecast — directly.

Verified Eligible · Not Yet Modeled

APCM — The Build-Toward Target

Advanced Primary Care Management (G0556–G0558) is Medicare's bundled monthly payment for exactly the panel this program manages — and its value-model participation requirement is one Alabama Medical Group already meets, as a verified PY2026 MSSP Enhanced-track participant (ACO A4894). APCM is switched off in this model and carries zero dollars anywhere on this page — it is named as a build-toward target, not as modeled revenue. The CCM-versus-APCM mix is a design decision to make together once real enrollment data exists.

The growth conversation, correctly framed: the way to raise this forecast is to widen the definition, not to push outreach harder. Validate real eligibility against chart data in discovery, then decide where APCM fits.
Implementation

Chartered in 30 Days.
Enrolling by Day 45.

CoachCare operates as the service line's engine — enrollment outreach, device logistics, 24/7 monitoring, and billing-ready documentation — while Alabama Medical Group physicians govern protocols and every clinical decision. Full-service delivery means launch requires no new practice headcount; month 1 carries the one-time setup, and the program runs margin-positive from month 2 onward.

The first 90 days, modeled: 67 active program enrollments by month 1, 178 by month 2, 330 by month 3 — concentrated in the CCM wave and the hypertension/diabetes RPM cohorts.
0–30 Days

Charter the Service Line

Named owner, P&L, scorecard; Veradigm integration scoped and the exact product configuration confirmed in contracting; billing configuration; protocol sign-off for the HTN, diabetes, HF, CKD, and COPD pathways.

31–90 Days

Launch the First Cohorts

The CCM wave across the multi-chronic panel plus RPM for the hypertension and diabetes cohorts; the CoachCare-funded enrollment specialist on site at the Mobile campus; TCM live on every discharge.

91–180 Days

Scale to the Ceilings

Enrollment extends across the Mobile and Saraland locations; RPM approaches its modeled 1,934-patient ceiling around month 20 while CCM keeps climbing past month 24; monthly scorecard reporting to practice leadership.

181–365 Days

Widen the Definition

Re-validate eligibility against real chart data, decide the CCM-vs-APCM mix on the verified-eligible slice of the panel, and align program reporting with the ACO's quality and cost measures.

About CoachCare

The Experience to Get It Right

The service line described on this page runs on infrastructure already proven at national scale.

500,000+

Patients Managed

Over 400 managed conditions for 500,000+ patients.

10,000+

Clinicians on the Platform

Providers running remote care programs on the CoachCare platform.

1,000+

Implementations

Programs implemented and operating in market.

5M+

Claims Generated

Care plan coding and billing that has produced over 5 million claims.

100M+

Vitals Recorded

Over 100 million vitals recorded and 4 million+ care actions enabled.

Policy Watch · CMS-1848-P

2027 Proposed Rule Insights

CMS's CY2027 Physician Fee Schedule proposed rule, published July 16, 2026, proposes to reprice remote physiologic monitoring. Here is what it reaches, what it leaves alone, and how the operating model behind this service line absorbs it.

1

The Proposal Is Confined to RPM

CMS's remote-monitoring proposals sit in one code family: RPM. CCM, PCM, and TCM are not part of them. That distinction lands directly on this forecast — CCM carries $2,350,935 of the modeled $4,811,041 in 24-month net reimbursement, and the TCM touch at discharge is outside the proposal entirely. Neither is in scope.

2

CoachCare Is Building the Contingencies Now

The delivery model has more than one shape, and CoachCare is preparing each so the service line's economics hold wherever the rule settles. One unbundles the program into its parts — SaaS platform, device logistics, and program enablement — priced as components. Another engages CoachCare to run the staffing itself, an MSO-style arrangement in which the practice owns the clinical program and the billing while CoachCare carries the labor model. Neither requires re-architecting the service line described on this page.

3

ACCESS Moves Remote Care to Risk-Based PMPM

Alongside the fee schedule, CMS's ACCESS Model pays remote care as a risk-based per-member-per-month arrangement rather than per code: recurring per-beneficiary payments, half of each one withheld and reconciled against outcome attainment. Cardiometabolic care is among its four clinical tracks. What earns under that structure — controlled pressures, titrated therapy, decompensations caught early — is what this service line is built to produce.

What the Proposal Actually Takes Off This Forecast

This forecast repriced code by code at CMS's CY2027 proposed values, at this practice's own MAC locality rather than national averages. Same enrollment, same phasing plan — only the rates move.

−20.6%
The headline per-code cut — device supply (99454 / 99445), the code the proposal reprices hardest.
→
−8.7%
The RPM patient-year, because device supply is only 30% of it — the management codes barely move.
→
−5.5%
The whole service line, because CCM carries 48.9% of the forecast and is not in scope.
RPM alone — the only code family in scope$2,460,106 over 24 months
−$214,437
−8.7% of RPM
The whole service line — RPM + CCM$4,811,041 over 24 months
−$264,209
−5.5% of the whole

Both bars run on the same dollar scale, so the red slice is nearly the same width in each — the same dollars, measured against a larger base. The empty track on the top bar is the care-management revenue RPM alone does not include.

RPM, retained at CY2027 proposed rates The proposed reduction CCM — not in scope

Repriced at this locality's own geographic adjusters. The RPM reductions fall almost entirely on practice expense, so the untouched work component carries more weight in some localities than others; the same repricing at national rates would be −8.8% on RPM. Of the $264,209, RPM accounts for $214,437 and the care-management arm for $49,772.

Where the Proposal Lands, Code Family by Code Family

CY2026 versus CMS's published CY2027 proposed values, shown at national non-facility amounts so they can be read against CMS's own tables. This practice's locality-adjusted amounts differ; the repricing above uses the local figures.

Code familyWhat CMS proposedCY2026CY2027 proposedChange
In scope — remote physiologic monitoring
99454 / 99445 · device supplyPractice expense recrosswalked$52.11$41.38−21%
99457 · management, first 20 minDirect practice expense removed$51.77$49.59−4%
99458 · management, each addl 20 minDirect practice expense removed$41.42$40.39−2%
99453 · setup and patient educationCrosswalked; one-time per patient$21.71$20.03−8%
Not in scope — the codes the proposal does not reach
99490 / 99439 / 99491 · CCMNo structural change proposed$66.13$64.04−3%
99495 / 99496 · TCMNot addressed by the proposalOutside the remote-monitoring provisions entirely

National non-facility amounts; CY2027 values are CMS's own published proposals in Addendum B of CMS-1848-P. The care-management rows show the lead code in each family; every code in those families moves within about 4% in either direction, which is ordinary annual movement rather than a repricing. The RPM reductions are also phased — section 1848(c)(7) of the Act caps any one code's total-RVU reduction at 19% in a single year, and CMS publishes the affected codes, so CY2027 is a single-digit year for a typical program and the remainder arrives no earlier than CY2028.

None of this is final. CMS-1848-P is a proposed rule. Comments are due September 14, 2026, the final rule is expected in early November, and it takes effect January 1, 2027. CoachCare is leading the advocacy — filing comments, putting the device cost and pricing evidence in front of CMS that the rule itself states the agency does not have, and helping practices file their own. This practice gets the final rates, and the model rerun against them, the week they publish.
Why CoachCare for Alabama Medical Group

Built for the Way This Practice Runs

Six reasons this partnership fits Alabama Medical Group specifically, not remote care in general.

Veradigm

We run inside the chart you already use

CoachCare integrates bi-directionally with Veradigm: eligibility flags and orders leave the EHR, and discrete vitals, care documentation and claim-ready charges come back into it. One chart for the primary-care physicians, one workflow for the billing team, and no second system to learn to start.

Full service

The model that runs without hiring

Enrollment outreach, the care team, device logistics, 24/7 alert triage and billing preparation sit on CoachCare's payroll. The practice inherits a running program the month it turns on, at a 42.7% margin, with no hiring cycle. On-site enrollment is our expense — telephonic outreach converts about 8%, so we staff the clinic instead.

Governance

The practice stays in charge

Your physicians set the protocols, sign the care plans and make every clinical decision, and claims go out under the group's own entity and NPIs. CoachCare supplies the staff, devices, platform and billing preparation under that governance — the operating model an independent primary-care group keeps control of.

Service line

One spine under the ACO

An MSSP Enhanced track carries full downside risk, where retrospective assignment rewards broad, low-friction chronic-care enrollment over a shortlist. The RPM and CCM stack is exactly that enrollment engine — it earns fee-for-service dollars now and builds the managed panel the ACO is scored on. One service line, both jobs.

Chronic-care panel

Built for a multi-chronic panel

The RPM and CCM programs are close to an even split on revenue, with CCM carrying the larger share of margin — exactly what a multi-chronic primary-care panel should produce. Top-tier APCM sits on top for the members who qualify, documented monthly, so the highest-need patients are managed on the right code.

Aligned

Paid as you enroll — no capital, no lock-in

Fees are per active patient per month; there is no capital outlay and no payroll ramp. Because the forecast is set by enrollment pace, throughput is the lever. If the census does not build, CoachCare does not get paid, and the forecast, Disclosures and workbook behind this page are yours to keep either way.

The ask: a working session to validate the Medicare panel against your own chart counts, scope the Veradigm interface, confirm the ACO track and attribution, and set the go-live cohort.