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.
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.
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.
Founded 1946 — the largest independently owned, multi-specialty medical clinic in Mobile, Alabama, celebrating 80 years in 2026.
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.
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.
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.
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.
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.
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.
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.
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.
| Service | Codes | ~CY2026 Magnitude | Use Across the Panel |
|---|---|---|---|
| Chronic Care Management | 99490 · 99439 | ~$60 + ~$47 add'l | The longitudinal wrapper — 2+ chronic conditions |
| RPM setup & device supply | 99453 · 99454 · 99445 (new) | ~$20 setup · ~$52/mo | HTN, diabetes, HF cohorts; 99445 unlocks 2–15-day windows |
| RPM treatment management | 99457 · 99458 · 99470 (new) | ~$52 + ~$41 add'l | Monthly review, titration, escalation |
| Transitional Care Management | 99495 · 99496 | ~$200 / ~$280 | Every 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.
The same infrastructure — enrollment, devices, alerts, follow-up, documentation, billing — compounds across every layer of value an independent internal-medicine group cares about.
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.
successful program implementations across EMR environments — including the Veradigm family the practice runs today.
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.
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.
| Program | Net reimbursement | CoachCare fees | Practice 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.
Recurring, subscription-like professional-fee volume over 24 months.
A continuous clinical picture of the HTN, diabetes, HF, CKD, and COPD panels between visits.
≈ $2.8M in avoided acute cost at $15K per admission — utilization relief the ACO's shared-savings math rewards.
≈ 43,633 care-team hours of monitoring, outreach, and documentation handled by the service line — not by practice staff.
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.
| Program | Enrollment Ceiling | How It's Defined | Saturates |
|---|---|---|---|
| RPM | 1,934 | 8,500 × 65% eligible × 35% acceptance | Month 20 |
| CCM | 1,913 | 8,500 × 75% eligible × 30% acceptance | Not inside 24 mo |
| At month 24 | 3,791 | Active 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.
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.
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.
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.
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.
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.
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.
The service line described on this page runs on infrastructure already proven at national scale.
Over 400 managed conditions for 500,000+ patients.
Providers running remote care programs on the CoachCare platform.
Programs implemented and operating in market.
Care plan coding and billing that has produced over 5 million claims.
Over 100 million vitals recorded and 4 million+ care actions enabled.
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.
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.
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.
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.
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.
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.
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.
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 family | What CMS proposed | CY2026 | CY2027 proposed | Change |
|---|---|---|---|---|
| In scope — remote physiologic monitoring | ||||
| 99454 / 99445 · device supply | Practice expense recrosswalked | $52.11 | $41.38 | −21% |
| 99457 · management, first 20 min | Direct practice expense removed | $51.77 | $49.59 | −4% |
| 99458 · management, each addl 20 min | Direct practice expense removed | $41.42 | $40.39 | −2% |
| 99453 · setup and patient education | Crosswalked; one-time per patient | $21.71 | $20.03 | −8% |
| Not in scope — the codes the proposal does not reach | ||||
| 99490 / 99439 / 99491 · CCM | No structural change proposed | $66.13 | $64.04 | −3% |
| 99495 / 99496 · TCM | Not addressed by the proposal | Outside 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.
Six reasons this partnership fits Alabama Medical Group specifically, not remote care in general.
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.
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.
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.
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.
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.
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.