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Care management programs for organizations of every size—delivered nationwide.

Talk With a Care Strategist
Who We Serve

Built for the wayhealthcare is actually organized.

Care management does not happen in one type of building, one specialty, one EHR, or one organizational structure.

MatterCCM adapts its operating model to the people, systems, responsibilities, and patient populations already present within each organization.

One practiceA groupA network
Independent Practices

Add a care-management operation without building one from the ground up.

Small practices frequently have eligible patients and strong provider relationships but limited administrative and clinical capacity.

We provide the people, workflows, controls, patient engagement, documentation, and reporting required to establish a serious program without expecting the practice to hire, train, supervise, and equip an entirely new department.

The model is designed to complement the practice—not overwhelm it.

Common Priorities
  • Increasing support between visits
  • Reducing staff burden
  • Improving patient retention and engagement
  • Creating a sustainable care-management workflow
  • Supporting appropriate documentation and billing
  • Preserving the provider-patient relationship
Multispecialty Groups

One operating standard across different specialties and locations.

Multispecialty organizations require consistency without losing clinical relevance.

A cardiology patient should not experience the same care-plan conversation as a rheumatology patient. A large primary-care population may require a different workflow from a smaller specialty cohort. Providers may use different escalation pathways. Locations may have different staffing structures.

MatterCCM helps establish common operating controls while configuring care delivery around the needs of each population.

Common Priorities
  • Cross-specialty coordination
  • Shared program governance
  • Location-level performance
  • Consistent documentation standards
  • Provider-specific escalation
  • EHR workflow alignment
  • Scalable patient enrollment
Hospitals and Health Systems

Extend continuity beyond episodic care.

Hospitals and integrated delivery systems often have the greatest need for coordination—and the greatest operating complexity.

MatterCCM can support longitudinal engagement across large populations, multiple clinical departments, diverse care settings, and distributed leadership structures.

Common Priorities
  • Enterprise implementation
  • Multi-location workflows
  • Post-discharge continuity
  • Population segmentation
  • Specialty coordination
  • Centralized governance
  • Quality assurance
  • Executive reporting
  • Scalable patient operations
Skilled Nursing and Long-Term Care

Coordinate around patients whose care rarely belongs to one team.

Patients in skilled nursing and long-term care environments often interact with facility staff, attending providers, specialists, pharmacies, therapists, hospitals, families, and external care organizations.

We can help establish a structured coordination model around those relationships.

Potential Program Considerations
  • Complex chronic-condition burden
  • Medication changes
  • Functional limitations
  • Cognitive impairment
  • Caregiver and family involvement
  • Facility communication
  • Specialist coordination
  • Hospital and post-acute transitions
  • Recurring clinical escalation
  • Multiple sources of patient information

Our workflows are designed around the facility and provider structure involved in the patient’s care.

Rehabilitation and Post-Acute Care

Support recovery without losing sight of the chronic conditions underneath it.

A rehabilitation episode may focus on recovery from a specific event, while the patient continues to live with hypertension, diabetes, COPD, heart disease, depression, arthritis, or other long-term conditions.

MatterCCM helps organizations maintain visibility across both the recovery journey and the patient’s broader care needs.

Common Priorities
  • Transition follow-up
  • Medication understanding
  • Appointment coordination
  • Monitoring after discharge
  • Caregiver engagement
  • Chronic-condition continuity
  • Escalation of emerging concerns
  • Coordination with community providers
ACOs, IPAs, and MSOs

Central infrastructure. Local clinical relationships.

Networks need scalable programs, but affiliated practices cannot always be treated as identical operating units.

MatterCCM can provide centralized program infrastructure while allowing defined workflows, provider relationships, and escalation structures to remain local.

Common Priorities
  • Network-wide population analysis
  • Repeatable implementation
  • Practice onboarding
  • Central reporting
  • Local workflow flexibility
  • Quality and risk visibility
  • Value-based care support
  • Program standardization
FQHCs and Rural Health Organizations

Practical support for populations with complex barriers to continuity.

Patients may face transportation limitations, connectivity challenges, health-literacy barriers, limited specialist access, financial pressures, and other circumstances that affect their ability to follow a care plan.

MatterCCM can help configure patient engagement and care coordination around the realities of the population.

Specialty Programs

Programs may be developed for or alongside specialties including:

  • Primary care
  • Family medicine
  • Internal medicine
  • Geriatric medicine
  • Cardiology
  • Endocrinology
  • Pulmonology
  • Nephrology
  • Rheumatology
  • Oncology
  • Neurology
  • Psychiatry and behavioral health
  • Pain management
  • Gastroenterology
  • Orthopedics
  • Rehabilitation medicine
  • Podiatry
  • Other chronic and complex-care specialties
Built for Every Scale of Care

Enterprise discipline without an enterprise-only attitude.

A smaller practice should not need to create an internal department to offer coordinated care.

A large healthcare organization should not have to force multiple locations, specialties, EHRs, and patient populations into a rigid program template.

MatterCCM is designed to support both.

Independent Practices

Add care-management capacity without placing another operational burden on a small team.

Hospitals and Health Systems

Extend longitudinal engagement beyond episodic encounters with structured governance, scalable workflows, and leadership reporting.

Multispecialty Groups

Create a consistent operating model while respecting differences among specialties, providers, locations, and patient populations.

Skilled Nursing and Long-Term Care

Coordinate complex populations across facility teams, primary care, specialists, pharmacies, caregivers, and transitions.

Rehabilitation and Post-Acute Care

Support patients whose recovery and chronic conditions require continuity across changing care settings.

ACOs, IPAs, and MSOs

Deploy repeatable care-management infrastructure across affiliated organizations without losing local workflow flexibility.

Our Care Management Programs

One partner for a more connected continuum of care.

Service

Chronic Care Management

Structured, recurring support for eligible patients living with multiple chronic conditions.

We help manage patient identification, enrollment, individualized care planning, meaningful monthly engagement, medication review, coordination across providers and settings, documentation, and billing readiness.

Service

Complex Chronic Care Management

Higher-touch support for patients whose medical, functional, behavioral, or social complexity requires more intensive coordination and clinical attention.

Programs are configured around population needs, provider protocols, escalation requirements, and the organization’s clinical governance structure.

Service

Remote Patient Monitoring

Connected-device programs that turn patient-generated health information into structured clinical action.

MatterCCM supports device strategy, patient onboarding, adherence, monitoring workflows, threshold management, patient communication, escalation, documentation, and program oversight.

Program Sizing

See the scale of the opportunity in your own panel.

Move the slider to the number of Medicare patients in your practice. The figure below is an estimate for discussion, not a quote.

Estimated monthly program revenue

$13,000

200 patients × $65 per enrolled patient per month.

Estimate only. Assumes every eligible patient is enrolled and completes the monthly service requirement. Actual figures depend on enrollment rate, payer mix, documentation, and the CPT codes billed. Nothing here is a guarantee of reimbursement.

Your organization does not need to resemble anyone else’s.

Tell us how your patients receive care today. We will help determine how a managed care program can fit your population, providers, facilities, technology, and operating structure.