Insights and resources

Practical ideas for care teams

Perspectives on follow-up care, healthcare technology, and ways to improve patient outcomes.

Featured article

Primary care clinician listening to an older patient during a consultation.

Behavioral HealthOctober 12, 20264 min read

Collaborative care model: How primary care teams organize behavioral health follow-up

How primary care teams use the collaborative care model (CoCM) to follow patients, track symptoms, and coordinate psychiatric review.

Read the article

Articles

Latest articles

Patient Engagement4 min read
“I’m Fine”: The Two Words That Don’t Tell the Whole Story
“I’m fine” may leave care teams with an incomplete picture. Discover five questions that reveal barriers to a care plan and guide better follow-up.
September 28, 2026Read
Best Practices8 min read
Your RPM Dashboard Is Full. But What’s Actually Happening With All That Data?
Your RPM dashboard can be full of patient readings and alerts. The bigger question is what happens next and whether the right action actually follows.
September 17, 2026Read
Industry Trends6 min read
Could a Rule Meant to Protect Remote Monitoring End Up Weakening Connected Care?
CMS is right to target opaque, low-value remote monitoring. But employment status alone may not solve the accountability problem.
August 20, 2026Read
Best Practices8 min read
The Staffing Gap Behind Remote Care: When an Extension of the Clinical Team Makes Sense
Learn when remote clinical staffing can extend care teams, support RPM and CCM workflows, and preserve continuity as patient volume grows.
August 13, 2026Read
Best Practices7 min read
Home Is Where Complexity Shows Up: Supporting Patients With Multiple Chronic Conditions Between Visits
Multiple chronic conditions do not pause between visits. Learn how structured care helps teams support complex patients at home.
August 12, 2026Read
Behavioral Health8 min read
The Missing Context in Chronic Care: Bringing Behavioral Health Into the Patient Story
Behavioral health integration helps care teams connect chronic care data with patient context, improve follow-up, and build realistic care plans.
August 11, 2026Read
Billing & Revenue6 min read
The Care Happened. Can the Record Prove It?
Learn how clear RPM and CCM documentation helps prove care delivery, support Medicare billing compliance, and strengthen audit readiness.
August 7, 2026Read
Billing & Revenue7 min read
The 2026 Medicare Fee Schedule Through an Operational Lens: What RPM and CCM Teams Should Review
How the 2026 Medicare Fee Schedule affects Medicare care management, including RPM reimbursement, CCM billing, documentation, and workflow controls.
August 4, 2026Read
Technology5 min read
The two-way record: Why care management data must move back into the EHR
Why two-way EHR integration matters for RPM and CCM workflows, documentation, care coordination, and a more complete patient record.
July 31, 2026Read
Best Practices7 min read
Beyond monthly minutes: What CCM Documentation should reveal about the patient
Learn why CCM documentation should capture patient needs, care-team actions and follow-up—not just monthly minutes.
July 30, 2026Read
Technology8 min read
From reading to resolution: What a complete RPM workflow should capture
A complete RPM workflow should move every patient reading toward review, follow-up, documentation, escalation when needed, and clear resolution.
July 29, 2026Read
Technology7 min read
One Patient, Many Programs: What Connected Care Looks Like When RPM, CCM, and BHI Share a Workflow
See how RPM, CCM, and BHI share one connected workflow while preserving program-specific responsibilities.
July 28, 2026Read
Industry Trends5 min read
From Pandemic Response to Everyday Care: The Next Phase of RPM
A 2025 COVID-19 case study highlights why RPM needs connected workflows, patient follow-up, escalation, and EHR-connected documentation.
July 25, 2026Read
Best Practices4 min read
What clinics need to build sustainable Chronic Care Management Programs
Sustainable chronic care management requires whole-person assessment, patient-centered planning, coordinated support, and longitudinal monitoring.
July 15, 2026Read
Telehealth4 min read
Why Remote Patient Monitoring Needs More Than Devices
Remote patient monitoring creates value when vital-sign data lead to timely follow-up, clear documentation, and coordinated clinical action.
July 14, 2026Read
Industry Trends7 min read
Why Better Communication Is the Foundation of Healthcare Quality Assurance
What an early nursing informatics paper can teach today’s care teams about documentation, decision-making, and quality improvement.
July 13, 2026Read
Industry Trends5 min read
The Long History of Remote Patient Data: Why Care Management Still Needs Better Infrastructure
Healthcare’s data challenges are not new. Learn how remote data entry evolved into connected care workflows for modern care management.
July 10, 2026Read
Industry Trends2 min read
Why Remote Patient Monitoring Is a Smart Investment
With CMS expanding reimbursement codes and patient expectations shifting, RPM has never been more critical for healthcare organizations.
December 1, 2025Read
Billing & Revenue3 min read
Medicare RPM Billing Guide: CPT 99453, 99454, 99457 & 99458
Everything you need to know about CPT codes 99453, 99454, 99457, and 99458, including documentation requirements and common pitfalls to avoid.
November 28, 2025Read
Best Practices2 min read
5 Proven Strategies to Reduce Alert Fatigue in Your Care Team
Alert fatigue is real, and it's hurting patient care. Learn how smart alert prioritization and AI-driven triage can help your team focus on what matters most.
November 25, 2025Read
Behavioral Health2 min read
The Business Case for Behavioral Health Integration
Mental health and physical health are inseparable. Here's how integrating BHI into your primary care practice improves outcomes and opens new revenue streams.
November 22, 2025Read
Technology1 min read
How to Choose the Right Remote Monitoring Devices for Your Patients
Blood pressure monitors, glucose meters, pulse oximeters, with so many options, how do you pick? A practical guide to device selection and patient matching.
November 18, 2025Read
Getting Started2 min read
Building a Successful CCM Program from Scratch
Starting a chronic care management program? This step-by-step guide covers patient identification, enrollment, workflow design, and billing optimization.
November 15, 2025Read
Telehealth2 min read
Telehealth Etiquette: Best Practices for Virtual Patient Visits
Virtual visits are here to stay. These simple techniques will help you build rapport, conduct effective assessments, and leave patients feeling heard.
November 12, 2025Read
Value-Based Care2 min read
Understanding Value-Based Care: A Primer for Practice Managers
Fee-for-service vs. value-based care, what's the difference, and how can you position your practice to succeed in both worlds?
November 8, 2025Read
Patient Engagement2 min read
Patient Engagement Strategies That Actually Work
Getting patients to use their monitoring devices consistently is half the battle. Here are evidence-based techniques to boost adherence and engagement.
November 5, 2025Read
Technology2 min read
EHR Integration: What to Expect and How to Prepare
Connecting your care management platform to your EHR doesn't have to be painful. A realistic look at integration timelines, common challenges, and success factors.
November 1, 2025Read

Newsletter

New articles, once in a while

Practical writing on follow-up care, care coordination, and billing, sent to your inbox.