A COO/CFO playbook for turning Chronic Care Management into a standardized shared service across your network—without adding headcount.
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A practical guide for medical leadership and compliance teams on structuring outsourced care-management under Corporate Practice of Medicine laws.
If you're running an MSO or multi-site physician group, you don't need to be sold on Chronic Care Management (CCM).
You already know:
CCM should be a layup:
And yet many MSOs quietly admit they're leaving meaningful revenue and quality upside on the table because they can't stand up CCM consistently across 10+ sites without running into:
This playbook is written for COOs and CFOs who want to fix that—without adding headcount.
At single-practice scale, it's tempting to think:
"We'll just have our MAs do CCM calls."
At MSO scale, that breaks down fast.
Each practice is already short on nurses and MAs. Asking local teams to bolt CCM on top of in-clinic throughput leads to:
One practice builds a decent CCM workflow. Another hacks it together in spreadsheets. A third never really gets off the ground.
From an MSO view, that means:
The more ad hoc the model, the harder it is to ensure:
If each site adopts a different tech workaround, you end up with:
That's why CCM has to be built as a shared service—a single operating model that runs across participating practices.
Before you touch workflows or the EMR, define what "good" looks like at the MSO level.
A mature shared-services CCM program has:
1. One operating model across sites
Common eligibility criteria, consent scripting, call cadence, and documentation standards. No "home-grown" variants per practice.
2. A centralized care-management team
Pooled nurses, MAs, and navigators working across your network under physician supervision. Local clinicians keep clinical authority; centralized staff handle the work between visits.
3. EMR-embedded workflows
CCM notes, tasks, and time logs that live in the EMR you already use. Providers see CCM activity in the chart—not in a separate portal.
4. CPOM-sensitive governance
Clearly documented separation between clinical decision-making and operational support. Management agreements and BAAs that match how work actually happens.
5. Network-level measurement and ROI
Enrollment, engagement, time logged, net revenue per enrolled patient, and utilization trends by site, payer, and condition.
6. No incremental internal FTE requirement
You don't have to build a full care-management department in-house just to get CCM off the ground.
That's the bar: one model, many practices, no new internal headcount.
For an MSO, governance is the foundation.
You need clarity on:
Practical steps:
Get this right early and you drastically reduce "are we allowed to do this?" friction later.
MSOs struggle with multiple EHRs, inconsistent templates, and manual reporting.
Your CCM operating model should:
Ask this of your team (or partner):
"If an auditor looked only at the EMR, could they see exactly what we did and why we billed for CCM?"
If the honest answer is "maybe, but we'd have to pull spreadsheets," you don't have a real operating model yet.
Workforce constraints are structural, not temporary. Most MSOs do not want to stand up care-management FTEs at every practice.
Instead, a shared-services CCM team lets you:
You can build this team internally, or work with a partner that:
From a CFO's perspective, you're trading a fixed FTE ramp for a variable service line that can scale with adoption.
MSOs often leave meaningful revenue on the table because they:
A shared CCM engine should:
Treat CCM enrollment like a small growth engine, not an afterthought.
CCM is only valuable if it's billable and defensible.
Your model should ensure:
A shared service lets you refine one documentation pattern instead of fixing ten different local experiments.
Executives need more than "we enrolled 400 patients."
At a minimum, you want recurring views of:
Panel metrics
Financial metrics
Clinical & utilization metrics
Over time, this lets you:
Here is a realistic—but aggressive—timeline if you leverage a shared-services model instead of building everything on your own.
Outcome: A documented operating model and implementation plan your clinical, compliance, and finance leaders can support.
Outcome: A live CCM program in a subset of sites with real patients, real documentation, and a fast feedback loop.
Outcome: CCM running across 10+ sites on a single operating model—without the MSO having to hire, train, and manage a new internal care-management department.
From the research and real-world experience, a few patterns show up repeatedly.
Expecting already overloaded clinic staff to "fit in" CCM almost guarantees:
Every exception you allow creates another variant of CCM. That means:
Keep the operating model standard. Only allow exceptions when there is a truly material difference in how a site must work.
If nobody can clearly explain:
…you're one email away from a compliance headache.
Without consistent metrics, CCM will always feel squishy to finance and the board—even if it's doing important clinical work. That's usually when programs get cut.
Launching with the noisiest or least organized practices sets the program up to look chaotic. Start with sites that have:
By the one-year mark, a strong shared-services CCM program typically has:
At that point, CCM isn't just a program; it's infrastructure—a platform you can build RPM, BHI, and other value-based services on top of.
You can absolutely build this internally.
But for many MSOs, the trade-offs are clear:
LOGIC's model is to act as your centralized care-management team and operating model, running CCM (and related programs) inside your EMR, under your governance, across your sites—without requiring you to add internal FTE.
Concretely, that means:
If you'd like a concrete view of what a 90-day CCM rollout across your network could look like—with enrollment and revenue assumptions tuned to your payer mix—this is exactly the conversation we have with MSO COOs and CFOs every week.
