The 5-Question Framework Practices Should Use When Evaluating CCM Partners

"If you're a physician practicing chronic care management, you've probably been approached by a dozen vendors already.

They all promise the same things: better patient outcomes, improved quality measures, additional revenue, minimal lift from your staff.

But not all CCM partners are created equal. And the wrong choice can leave you frustrated, stuck in a contract that adds work instead of removing it, with patients who disengage after the first few calls.

I've seen it happen. Practices get burned and write off CCM entirely—when the real problem was who was delivering it, not the model itself.

So how do you tell the difference between a CCM vendor who checks boxes and a CCM partner who actually adds value?

Here's the 5-question framework I'd use:

Question 1: What's your clinical background?

This is the most important question and the one most practices don't think to ask.

Is the person calling your patients a licensed clinician? Do they have experience managing complex medication regimens? Can they answer pharmaceutical questions on the spot, or do they have to escalate everything back to you?

If your CCM provider can't handle clinical conversations independently, they're adding to your workload—not reducing it.

Question 2: How do you measure success beyond billing compliance?

Any CCM vendor can track 20 minutes and document a call. That's the bare minimum for billing.

But what are they actually measuring? Medication adherence rates? Patient satisfaction? Quality measure improvement? Hospital readmission rates? A1C trends?

If they can't tell you how they track real outcomes, they're focused on billing—not care.

Question 3: What happens when patients have questions outside your scope?

Chronic disease patients don't have simple questions. They want to know why their skin is so dry. Why they're exhausted all the time. Whether they can take a new supplement with their current medications. How to time their meds around meals.

Does your CCM partner have the expertise to address these issues? Or do they bounce everything back to your already-overloaded staff?

The best CCM partners expand what your practice can offer—not just extend your to-do list.

Question 4: How do you handle patients who disengage?

Patient engagement is the hardest part of CCM. Some patients stop answering calls. Some don't see the value. Some have barriers—health literacy, time, cost—that make engagement difficult.

What's the plan when that happens? Is there a re-engagement strategy? Are they identifying WHY patients disengage and addressing root causes?

If the answer is 'we document the attempt and move on,' that's not care management. That's data entry.

Question 5: How do you integrate with our existing workflow?

CCM should make your life easier, not harder.

How do they communicate with your team? How quickly do they flag urgent issues? Do they document in your EMR or create extra work for your staff? Do they feel like an extension of your practice or an outside vendor you have to manage?

A true CCM partner integrates seamlessly. You should barely notice they're there—except that your patients are doing better and your quality metrics are improving.

Here's the bottom line:

The right CCM partner brings clinical expertise, measures real outcomes, handles complex patient needs, fights for engagement, and fits into your workflow.

The wrong one tracks time, bills codes, and creates more problems than they solve.

Ask these five questions before you sign anything.

And if you're a practice in Texas that's been burned before—or you're exploring CCM for the first time and want to do it right—I'd love to talk about what a real partnership looks like.