CCM nurse during telehealth visitMany factors contribute to implementing or running a successful chronic care management (CCM) program. One significant driving factor is who actually interacts with your patients day-to-day.

It’s common for CCM service providers to operate under a model that employs medical assistants (MAs) or licensed practical nurses (LPNs) as the main point of contact between in-office staff and their patients. However, this model does not yield the best results.


Trusting outside professionals to engage with your patients does not always ensure they have the experience and knowledge needed to:

  • provide comprehensive care that goes beyond the basics.
  • eliminate in-office staff burdens.
  • drive impactful clinical outcomes.

That’s why leveraging a care team made up of 100% registered nurses (RNs) to staff your CCM program is best.

What makes this model better than others?

Larger Scope of Practice
A larger scope of practice is a key difference between CCM care models that leverage MAs and LPNs vs. a 100% RN-staffed model.

MAs or LPNs often fall into a care coordination role—executing upcoming appointment reminders, alerting patients of unscheduled preventive care visits, or helping find transportation to and from their doctor’s office. RNs, on the other hand, have the knowledge and expertise required for effective, in-depth chronic care management.

While care coordination and preventative care are still important aspects of a well-rounded CCM program, they are only a portion of the equation. Helping patients manage and treat their chronic conditions to make long-term impacts necessitates a more in-depth approach that LPNs and MAs usually can’t achieve.

RNs’ larger scope of practice allows them to go beyond the basics. They can handle various complex cases and navigate difficult patient health situations.

For example, our team of RNs helps patients across the entire spectrum of chronic care management: preventative care, disease management, and high-risk, complex care. Some patients may only need light touch points via care coordination to keep their health in check, while others may need a more involved plan to manage their chronic condition(s).

Our RNs can help with disease management and move patients along clinical pathways, teach them how to self-manage, and conduct motivational interviewing to support lifestyle choices. If a patient’s condition worsens, our RNs can assess them via telephone triage to determine if they need to come into the office or seek immediate care.

Again, this level of care is not in the scope of an LPN or MA.

Require Less Supervision
Because RNs have a larger scope of practice, they save in-office staff time and energy by working independently. And considering the unprecedented levels of burnout and staffing shortages the healthcare industry faces, this is essential to the success of any program.

An RN, compared to an LPN or MA, won’t have to reach out to your busy staff nearly as much because they can use their clinical judgment to effectively coach patients and independently handle most situations that arise.

Our chronic care management platform also integrates directly into EHRs, so our RNs’ can update patient records, requiring no additional work from your in-office staff. Plus, our system provides detailed reports for proper Medicare billing and compliance.

Some may struggle to feel fully confident in outsourced staff; however, our team of experienced CCM RNs has achieved 99% patient satisfaction, proving they can act as trusted liaisons between Medicare patients and their healthcare organization.

Drive Clinical Outcomes
Healthcare organizations often choose to outsource their CCM to companies that use MAs or LPNs because they believe they are saving more money. However, that’s not necessarily the case.

Because RNs have the knowledge and ability to engage with and educate patients on a deeper level, they have the potential to drive financially impactful clinical outcomes, such as preventing hospital admissions/readmissions and ER events.

Such outcomes open the door to added financial bonuses for those with i) value-based care (VBC) contracts or ii) quality-based incentives for fee-for-service populations.

Finding CCM Success with Registered Nurses
If your organization is considering implementing a CCM program, it’s in your best interest to find a partner backed by experienced RNs that you can trust to support your patients and drive impactful outcomes.

Our 100% RN chronic care management solution requires no upfront costs or additional work from your staff.

Wondering how our expert RNs could help your organization? Schedule a 15-minute demo.