Prepared for OVP Health Care · 2026 Strategy Review · Confidential — not for distribution
FQHC Look-Alike · Seven Sites, Five Counties, Three States · CY2026 Care-Management Rules

You Already Run the Highest-Touch Care Model in the Region. It Has Never Been Pointed at Chronic Disease.

OVP Health Care ranks in the top national quartile for substance use disorder treatment initiation and engagement — sustained contact with the patients most health centers lose track of. On every chronic-disease measure, the same organization ranks in the bottom quartile. Both depend on what happens between visits. One has the infrastructure and the other does not, and since January 1, 2026 the work of building it is separately billable Medicare revenue.

0
Unique Patients in Active Remote Care (Month 24)
$0
24-Month Net Reimbursement
$0
Net to the Health Center (24 Months)
0%
24-Month Margin to the Health Center

The headline counts 151 unique patients in active remote care at Month 24. The enrollment chart and the Scenario Explorer show 231 active program enrollments (services): CCM and APCM cannot be billed for the same patient in the same month, so the 61 CCM and 54 APCM enrollments are 115 distinct care-management patients. Most of the 116 RPM enrollments sit inside those cohorts as a second program on the same patient, and the balance are monitoring-only — together, 151 unique patients. Program enrollments are never labeled “patients.”

Start With What the Federal Data Already Says

Top National Quartile on the Hardest Population in American Medicine

Health centers report clinical quality to HRSA every year and are ranked against every other health center in the country. On substance use disorder treatment, OVP Health Care ranks in the best-performing quartile nationally — while carrying an SUD caseload that is 41.3% of the entire patient panel.

77.6%

SUD Treatment Initiation

Top national quartile. The share of patients who start treatment after diagnosis — the step most programs lose people at.

57.9%

SUD Treatment Engagement

Top national quartile. The share who stay in treatment. This is a between-visit measure, and OVP already wins it.

2,166

SUD Patients Served

Up from 578 two years earlier. Mental health rose from 222 to 1,077 across the same period.

The capability is already here. Keeping a substance use disorder patient engaged for months requires what chronic disease management requires: a named person who follows up, a defined cadence, documentation that survives staff turnover, and a way to reach someone who has stopped answering. OVP built that engine and runs it at top-quartile national performance. It has never been pointed at blood pressure and blood sugar.
The Same Report Card, The Other Half

Every Chronic-Disease Measure Sits in the Bottom Quartile

These are the measures that move when someone checks in between appointments, and they are the ones a quarterly office visit cannot reach. Two of them have a device attached.

Controlling High Blood Pressure

Share of hypertensive patients with blood pressure under control, against a 901-patient hypertensive cohort. Three consecutive years of decline, currently bottom national quartile. At 47.3%, 426 of the 901 are at goal and 475 are not.
CY202354.1%
CY202450.0%
CY202547.3%
Blood pressure is the most direct target remote monitoring has. A cuff at home produces a reading a week instead of a reading a quarter, and those readings arrive before the next appointment rather than at it.

Diabetes — HbA1c Poor Control Above 9%

Share of diabetic patients whose HbA1c exceeds 9%, against 556 diabetic patients — 213 of them sit above 9%. Lower is better. Bottom national quartile.
CY202339.3%
CY202434.0%
CY202538.3%
Glucose monitoring paired with a monthly care-management touch is the standard intervention, and it is billable under all three of the programs modeled below.
901

Patients With Hypertension

27.2% of the panel, up from 246 the year before as diagnosis capture improved. Across the Medicare panels specifically, hypertension prevalence runs 72–75%.

556

Patients With Diabetes

17.1% of the panel. Diabetes prevalence in the Medicare panels runs 29–54%, and chronic kidney disease 25–49%.

43.6%

Depression Screening & Follow-Up

Also bottom quartile, across 1,530 patients. The same monthly contact that carries blood pressure carries this one.

The CY2026 Reimbursement Change

Care Management Stopped Being an Unfunded Cost

G0511 — the single bundled code that paid health centers one flat amount for roughly twenty distinct care-management services — is gone. Since January 1, 2026, federally qualified health centers and look-alikes bill the individual CCM, RPM and APCM codes at national non-facility Physician Fee Schedule rates, each separately payable in addition to the PPS encounter rate.

Two rails, one claim

The encounter rate is untouched

PPS still pays for the visit. Care management and remote monitoring pay on top of it rather than folding into it, so a remote-care program does not cannibalize the encounter.

National rates

Geography stops mattering

These codes pay the national amount wherever the clinic sits. Every one of OVP's Medicare localities pays below national, so the correct rail is worth 5.6% to 7.6% more than local physician-fee-schedule rates across the code set.

The catch

New work arrived with the new revenue

Each program now needs its own time capture and its own documentation. That is the operational cost of the change, and it is the part CoachCare absorbs.

What OVP bills for remote care today. Across CY2023 and CY2024, a review of Medicare billing for every clinician who reassigns to OVP Health Care found no remote patient monitoring, no principal care management, no APCM and no transitional care management. CMS suppresses any line billed to fewer than eleven patients, so the accurate statement is that there is no billed remote-care program at meaningful scale — not that there are zero patients. Institutional care-management billing under the health center's own CCNs reports separately and is not visible in that data. The service line below is built on that basis.
The Service Line

Three Programs, One Care Team, One Enrollment Engine

Modeled across the 510 Medicare and dual-eligible patients in OVP's panel — the population where these codes pay at Medicare rates. CoachCare supplies the devices, the enrollment staff, the monitoring hours and the documentation. The health center supplies the panel and the clinical decisions.

RPM
$246,762
24-month net reimbursement

Remote physiologic monitoring. Blood-pressure cuffs and glucose meters that transmit on their own — 99453 setup, 99454 device supply, 99457 and 99458 treatment management, plus the CY2026 short-window codes 99445 and 99470. Reaches 65% of the in-scope panel and stacks with either care-management rail.

CCM
$153,575
24-month net reimbursement

Chronic care management. Monthly non-face-to-face management for patients with two or more chronic conditions, which at 72–75% hypertension prevalence is most of this panel. 99490 and 99439.

APCM
$74,588
24-month net reimbursement

Advanced primary care management. No minute thresholds and no time sheets — a monthly per-patient payment tiered by complexity. G0556, G0557 and G0558, where the top tier pays most for qualified Medicare beneficiaries who also carry Medicaid. 148 of the 510 are dual-eligible.

CCM and APCM split one pool. They do not stack. The two codes cannot be billed for the same patient in the same month, so they are modeled as a partition rather than a layer: APCM takes the dual-eligible slice where the top tier pays most, CCM takes the remainder. RPM sits on its own share because it can be billed alongside either. That is why 231 program enrollments resolve to 151 patients.
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Referring Clinicians
0
On-Site Enrollment Specialist — CoachCare's Expense
0
CoachCare-Delivered Hours (24 Months)
0
FTE-Equivalent of Care Capacity Added

Seven sites across five counties and three states, including a mobile unit in HRSA-approved scope since March 2024. Enrollment requires no one to travel: the on-site specialist works the highest-volume site and telephonic outreach covers the rest.

Native Epic Integration

The Program Runs Inside Epic

CoachCare builds on Epic's own workflows, so the care team enrolls and monitors patients without learning a second system. Readings, documentation and claims all land in the chart the clinicians already work in.

What Moves in Each Direction

Epic the health center's chart CoachCare devices, staff, monitoring Eligible patients · health history · enrollment orders Discrete vitals · care summaries · generated claims
Readings arrive as discrete vitals in the chart, not as scanned PDFs, so they are filterable, trendable and usable in the quality reporting that drives the UDS measures above.
1

Integrated enrollment

Enrollment flags and trigger ordering sit inside the clinical workflow. The CoachCare team enrolls qualified Medicare patients on the health center's behalf, and enrollment status is visible in Epic in real time.

2

Exchange of health history

Bi-directional at intake, so the care team starts with the same problem list, medications and history the clinic has.

3

Discrete vitals in the chart

Blood pressure, weight and glucose readings post as structured data on the patient record rather than as attachments nobody opens.

4

Audit-ready documentation

An integrated care summary lands in the record. Under the CY2026 individual-code rules each program needs its own time capture and its own documentation, and this is what substantiates the billed time when a payer asks.

5

Automated claim generation

Claims are created by the CoachCare billing engine. CoachCare is the only care-management application integrated with Epic that generates claims automatically, which removes the manual per-patient, per-month claim step entirely.

This is the answer to the operational half of the 2026 change. Unbundling G0511 into individual codes did not just create new revenue — it created new work: per-program time tracking and per-program documentation, every month, for every enrolled patient. A health center with one physician on staff cannot absorb that as manual effort. Enrollment inside the existing workflow, structured vitals on the chart and automatic claim creation are what make the new rules workable rather than expensive. Patients begin receiving CCM and RPM services in under five days from flag.
“Key to achieving a program that is efficient, effective and sustainable, is creating a seamless, intuitive user experience for the patient and provider, and that's what our integration with Epic accomplishes.”
Clinical Governance

Every Reading Routes Through One Escalation Engine

The economics prove the service line pays. This is what keeps it safe, and with one physician on staff it is the part the care team should read first.

1

A reading arrives out of range

The care team retakes it and screens for symptoms before anything escalates. A single high number is a measurement; a confirmed one is a finding.

2

Critical values escalate regardless of symptoms

A patient who feels fine with a critical reading still escalates. Feeling well is not a reason to wait.

3

Trends are defined objectively

Three readings at least an hour apart for blood pressure or glucose, or three within seven days for heart rate. Not a judgment call, and not a different threshold depending on who is working.

4

Unreachable patients still escalate

Voicemail and a callback attempt are logged, and a critical value or confirmed trend escalates anyway. Silence never closes a case.

5

Three routes, so the clinic sees signal

Emergencies go to 911. Non-critical findings go to a named member of the practice team. Stable and resolved goes into the record as an FYI, so the clinic is not paged for readings that resolved themselves.

6

Every escalation documents the same six things

Vital, findings, method of contact, who was reached, outcome, and follow-up. That record is also what substantiates the billed time.

The emergent pathway, and who owns it. Chest pain, new shortness of breath, stroke signs, syncope, a worst-ever headache or sudden swelling trigger a 911 call with the patient still on the line. If the patient refuses, the care team routes them to the clinic; if they refuse that, CoachCare activates 911. CoachCare's urgent and emergent policy supersedes any client-specific escalation preference — that is not adjustable in configuration, and it is why the clinic can delegate monitoring without inheriting the risk.
The post-discharge three-touch cadence. Any emergency-department visit or hospitalization in the previous sixty days triggers a fixed sequence: a call on day one or two, another on day five to eight, and a third on day twelve to fourteen. Those three touches are where the 16.9 avoided admissions in the forecast come from.
CoachCare Value Analysis · Modeled for OVP Health Care

The Value Analysis

A 24-month forecast across the 510-patient Medicare and dual-eligible population, 12 referring clinicians, one CoachCare-funded on-site enrollment specialist, telephonic enrollment, and CY2026 national non-facility PFS rates. Medicaid revenue, 340B pharmacy effects, transitional care management and the value of avoided admissions are not in these numbers.

Active Program Enrollments Under Remote Care

Monthly active census by program — active program enrollments, not unique patients; the headline is 151 patients. Provider referral plus one on-site enrollment specialist plus telephonic outreach, net of ~1.5% monthly attrition, with enrollment beginning in month 1. All three programs reach their eligible-population ceilings inside five months — APCM 54 in month 2, CCM 61 in month 4, RPM 116 in month 5. The plateau is the size of the Medicare panel, not a limit on enrollment pace.

Monthly Economics — Net Reimbursement, Fees, Net to the Health Center

Net reimbursement after denials and coinsurance bad debt, against total full-service fees including one-time implementation and integration. Month 1 is −$5,109, the only negative month, because one-time setup lands before the census ramps. Net to the health center turns positive in month 2 and settles near $9,341 per month. There is no negative-margin quarter. The chart is drawn against a true zero baseline so the month-1 dip is visible rather than hidden.

24-Month Net Reimbursement Mix

$474,925 in total. RPM leads because it reaches the widest slice of the panel at 65% eligibility, while CCM and APCM divide the care-management pool between them.

The Financial Summary

ProgramYear 1Year 224‑Month
RPM net reimbursement$112,303$134,459$246,762
CCM net reimbursement$72,240$81,335$153,575
APCM net reimbursement$36,368$38,220$74,588
Total net reimbursement$220,911$254,014$474,925
CoachCare fees (incl. one-time)$130,985$141,917$272,902
Net to the health center$89,926$112,097$202,023
Margin to the health center40.71%44.13%42.54%
The on-site enrollment specialist is staffed at CoachCare's expense and is already inside the fees above. It is never a separate cost to the health center.
16.9

Hospitalizations Avoided

Roughly $253,000 of avoided acute cost over 24 months. That value accrues to the health system and to payers rather than to OVP, so it is excluded from every revenue figure above.

26,619

Readings Captured

Blood pressure, weight and glucose readings arriving between visits, where the two failing quality measures are decided.

7,530

Claims Generated

Coded, documented and submitted with the time capture the CY2026 individual-code rules require.

3,245

Care-Team Hours Delivered

About 1.56 full-time equivalents of care-management capacity, added without the health center hiring anyone.

Scenario Explorer — Build Your Own Forecast

Adjust the assumptions and watch the 24-month forecast recompute. Eligibility is fixed at the CY2026 FQHC and look-alike row — 65% RPM, 40% CCM, 35% APCM of the in-scope panel — and the acceptance sliders sit on top of it. Because the in-scope population sets every program's ceiling, the population slider is the one that moves everything.
24-mo net reimbursement
$474,925
Net to the health center
$202,023
Active enrollments · M24
231
Unique patients · M24
151
Hospitalizations avoided
~17
Act Two

Medicare Is a Tenth of This Panel. Medicaid Is Half.

The forecast above covers 510 Medicare and dual-eligible patients. OVP serves 2,510 Medicaid patients — five times as many. Everything the service line builds for Medicare is the same equipment, the same enrollment staff and the same escalation engine. What differs is whether a given state pays for it, and the three states OVP operates in answer that three different ways.

Ohio — where it works

Remote monitoring is paid separately from the encounter

Ohio rule names remote patient monitoring as a service a health center may claim as a non-PPS service, and states that providing one on the same date as a PPS service does not preclude payment for either. That is incremental revenue, not a repackaged encounter. Ohio also pays APCM. Four of OVP's seven sites are in Ohio — Wheelersburg, Proctorville, Gallipolis and the mobile unit. Two conditions apply: a second Ohio provider number is required to bill non-PPS services, and no wraparound applies to them.

Kentucky — covered, inside the visit

RPM and CCM roll into the encounter rate

Kentucky covers remote monitoring and chronic care management under a dedicated regulation. But because those services count as a visit, they generate the encounter rate through wrap payment rather than an additional line. Worth building for the clinical result and the quality measures; not worth modeling as new revenue.

West Virginia — not yet

RPM and CCM are not covered

The state fee schedule lists the remote monitoring and chronic care management codes and marks them not covered. Transitional care management is covered and pays well, and it is the one care-management line available in West Virginia today.

The sequencing this implies. Build the Medicare service line across all seven sites first — it is federal, it pays the same everywhere, and it reaches its full eligible population inside a quarter. Then extend the same infrastructure into Ohio Medicaid, where the incremental revenue is real and where most of OVP's sites already sit. Kentucky and West Virginia come along for the clinical and quality benefit, and change when their coverage does.
Getting Started

Live in 30 Days

Week 1

Confirm the panel and open the Epic ticket

Pull the exact Medicare and dual-eligible count from the practice management system, identify which Epic instance OVP runs on so the interface request goes into the right queue, and agree which site starts. The 601 20th Street Huntington clinic runs the longest hours of any site and entered scope most recently.

Weeks 2–3

Build the Epic interface and configure

Enrollment flags and trigger orders built into the existing workflow, discrete vitals mapped to the chart, escalation routing set to the practice's own contacts, documentation templates mapped to the CY2026 individual-code requirements, devices staged, and the on-site enrollment specialist placed.

Week 4

First patients enrolled

Enrollment begins in month 1 — there is no dormant onboarding period. The mobile unit and the telephonic pathway extend reach beyond the flagship site from the start.

Months 2–5

Full eligible population enrolled

APCM reaches its ceiling in month 2, CCM in month 4 and RPM in month 5. From there the conversation turns to Ohio Medicaid and to the quality measures the program was built to move.

About CoachCare

The Experience to Get It Right

500,000+

Patients Managed

Over 400 managed conditions.

10,000+

Clinicians on the Platform

Providers running remote care programs day to day.

1,000+

Implementations

Programs stood up and running in market.

5 million+

Claims Generated

Care-plan coding and billing behind more than five million claims.

100 million+

Vitals Recorded

Over 100 million vitals recorded and more than 4 million care actions enabled.