Prepared for MedCura Health · 2026 Strategy Review · Confidential — not for distribution
Federally Qualified Health Center · Metro Atlanta · CY2026 Care-Management Rules

You Meet Patients Where They Are. Medicare Now Pays for the Time Between Visits.

MedCura Health cares for 36,741 metro-Atlanta patients across 16 locations — among them 2,935 with Medicare, a third of whom are dually eligible. Since January 1, 2026, health centers bill chronic care management, remote monitoring and advanced primary care management as individual codes at national rates, on top of the PPS encounter. Modeled on MedCura's own CY2025 panel, that is a $2.19 million service line over 24 months — with the enrollment and monitoring labor carried by CoachCare.

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

The headline counts 866 unique patients in active remote care at Month 24. The enrollment chart and the Scenario Explorer show 1,328 active program enrollments (services): CCM and APCM cannot be billed for the same patient in the same month, so the 352 CCM and 308 APCM enrollments are distinct patients, and RPM's 668 largely overlap them.

Start With What the Record Shows

A Safety Net That Kept Growing

MedCura Health has been metro Atlanta's community health center since 1980 — through a rename, a pandemic, and this February, a merger that brought Whitefoord's eastside clinics and school-based health centers into the family. The through-line has never changed: care that meets people where they are, in the language they speak.

36,741

Patients Across Metro Atlanta

Up 9.5% in two years. Sixteen locations spanning DeKalb, Fulton, Rockdale and Cobb counties — neighborhood clinics, school-based health centers and a dental satellite.

45+

Years of Continuous Service

Founded as Oakhurst Medical Centers in 1980 and renamed MedCura Health in 2020 — “Medicine with Care.” An FTCA-deemed, HRSA-funded Section 330 health center.

12+

Languages Spoken

Care delivered in Spanish, French and more than a dozen African dialects, for a panel where one patient in ten is best served outside English.

✓ Digital Spine

athenaOne at every site, for every provider

MedCura's own federal health-IT reporting attests a single enterprise EHR, with a patient portal, secure messaging and automated care-gap outreach already running.

✓ Value-Based Tenure

Thirteen years inside a Medicare ACO

A Shared Savings Program participant since 2013 through Accountable Care Coalition of Georgia — now in an ENHANCED, two-sided agreement where total cost of care is real money in both directions.

✓ Pharmacy Rail

340B with free prescription delivery

A 340B covered entity with contracted pharmacies and no-cost delivery to the patient's door — an engagement rail that already reaches people at home, where remote care lives.

The infrastructure for between-visit care already exists here. The enterprise EHR, the pharmacy delivery rail, the school-based footprint, the multilingual staff. The one rail it has not been pointed at is Medicare care management — the rail that, since January 1, 2026, pays health centers individual-code rates for exactly this work.
The Same Federal Report, Read Forward

Both Flagship Measures Are Decided Between Visits

Every health center reports clinical quality to HRSA each year. MedCura's CY2025 report identifies 5,140 patients with hypertension and 2,713 with diabetes — registries most practices would have to build from scratch. On the two measures those registries feed, there is headroom to the national health-center average — and the difference is not what happens in the exam room. Blood pressure and A1c are decided in the ninety days between appointments, where visit-based care cannot see.

Controlling High Blood Pressure

Share of hypertensive patients with blood pressure under control, against a 5,140-patient registry. Seven points of headroom to the national health-center average — and every one of them lives between visits.
CY202461.4%
CY202561.9%
National69.1%
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 a 2,713-patient registry. Lower is better — and the measure moved six points in the wrong direction last year.
CY202431.7%
CY202538.0%
National26.3%
Glucose data arriving between visits, paired with a monthly care-management touch, is the standard intervention — and it is billable under all three programs modeled below.
2,969

Patients 65 and Over

Plus a meaningful under-65 Medicare population — disability and ESRD — consistent with the panel's dual-eligible skew. Chronic-condition prevalence runs high in both groups.

2,935

Medicare-Primary Patients

The population where these codes bill at Medicare rates — MedCura's 2,716 plus the 219 who arrived with Whitefoord this year.

1,034

Dually Eligible

35% of the Medicare panel carries Medicaid alongside Medicare — which drives the top APCM tier and removes the cost-sharing barrier for the patients least able to absorb 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 bill the individual CCM, RPM and APCM codes at national non-facility rates, each separately payable in addition to the PPS visit.

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.

Set by statute

One national rate, everywhere

These codes pay the same national amount at every MedCura site — Stone Mountain to Smyrna to the school-based clinics. The rate card is set in Washington, not by the locality index.

The catch

New work arrived with the new revenue

Each program now needs its own time capture and its own documentation, every month, for every enrolled patient. That is the operational cost of the change — and the part CoachCare carries.

What MedCura bills for remote care today. A review of CY2024 Medicare billing across the clinicians enrolled under MedCura Health found no remote physiologic monitoring, no individual chronic care management, no APCM and no transitional care management — no Medicare remote-care program is visible in the claims record. The registries exist; the service line that pays for working them does not exist yet. CY2026 is the first year the codes do.
The Value-Based Layer

Thirteen Years in an ACO — Which Now Pays for Knowing Patients Between Visits

MedCura has participated in the Medicare Shared Savings Program since 2013 through Accountable Care Coalition of Georgia — today in an ENHANCED-track agreement, the two-sided kind, where the total cost of attributed patients is real money in both directions.

Attribution

Assignment follows primary-care services

Medicare assigns beneficiaries to the ACO based on where they receive primary care — and documented monthly care management is exactly that evidence. A patient touched every month is a patient whose assignment holds.

Two-sided stakes

Avoided admissions land on the ACO scoreboard

This plan projects 71 avoided hospitalizations over 24 months — roughly $1.07 million of acute cost that never hits the total-cost result MedCura now shares in, upside and downside alike.

The quality gate

Savings only pay out through quality

Shared savings require passing the quality gate — and the gate scores blood-pressure control and A1c. The same registries, the same measures, the same data this service line moves.

Build once, get paid three ways. Fee-for-service revenue on every enrolled patient. Total-cost protection on the attributed population. Quality movement that HRSA and the ACO gate both score. One enrollment engine, one device fleet, one documentation trail.
The Service Line

Three Programs, One Care Team, One Enrollment Engine

Modeled across the 2,935 Medicare and dual-eligible patients in MedCura's CY2025 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 what it already has: the patients and the clinical relationship.

RPM
$1,043,102
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.

CCM
$742,158
24-month net reimbursement

Chronic care management. Monthly non-face-to-face management for patients with two or more chronic conditions — most of a Medicare panel whose hypertension registry alone holds 5,140 patients. 99490 and 99439.

APCM
$408,948
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 $117 a month for qualified Medicare beneficiaries who also carry Medicaid. 1,034 of MedCura's Medicare patients are dually 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-heavy slice where the top tier pays most, CCM takes the multi-chronic remainder, and RPM runs alongside either.
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Referring Adult-Medicine Clinicians
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On-Site Enrollment Specialist — CoachCare's Expense
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CoachCare-Delivered Hours (24 Months)
0
FTE-Equivalent of Care Capacity Added

Sixteen locations across four counties. The enrollment model is built multilingual — Spanish, French and African-dialect outreach to match the panel — and no clinician adds a task: the on-site specialist works the registries, and the CoachCare monitoring team carries the month.

Native athenahealth Integration

The Program Runs Inside athenaOne

MedCura runs athenaOne at every site, for every provider — its own federal health-IT filings attest it two years running. CoachCare builds on athenahealth's built-in workflows, so the care team enrolls and monitors patients without learning a second system. Readings, documentation and claims all land in the chart the clinic already lives in.

What Moves in Each Direction

athenaOne 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 — 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, status visible in athenaOne in real time — and patients begin receiving CCM and RPM services in under five days.

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 anyone asks.

5

Automated claim generation

Claims are created by the CoachCare billing engine. CoachCare is the only care-management partner integrated with athenahealth 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 created new revenue and new work in the same stroke: per-program time tracking and per-program documentation, every month, for every enrolled patient. Inside athenaOne, that work is generated by the platform rather than added to the front desk.
“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 athenahealth accomplishes.”
Clinical Governance

Every Reading Routes Through One Escalation Engine

The economics prove the service line pays. This is what keeps it safe — and what lets 16 busy clinicians delegate monitoring without inheriting noise.

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 on retake.

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 to the clinic — and CoachCare's urgent and emergent policy supersedes any client-specific escalation preference, always.
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. That cadence is where the 71 avoided hospitalizations in this plan come from — and where the ACO's total-cost result is defended.
CoachCare Value Analysis · Modeled for MedCura Health

The Value Analysis

A 24-month forecast across the 2,935-patient Medicare and dual-eligible population, 16 referring adult-medicine clinicians, one CoachCare-funded on-site enrollment specialist, telephonic enrollment, and CY2026 national non-facility rates. Medicaid revenue, 340B economics and grant funding sit outside the model entirely.

Active Program Enrollments Under Remote Care

Monthly active census by program — active program enrollments, not unique patients; the headline is 866 patients. Provider referral plus one on-site enrollment specialist plus telephonic outreach, net of ~1.5% monthly attrition, with enrollment beginning in month one.

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 −$1,878, the only negative month, because one-time setup lands before the census ramps. Net to the health center runs ~$52,400 a month at steady state.

24-Month Net Reimbursement Mix

$2,194,208 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$291,919$751,183$1,043,102
CCM net reimbursement$274,083$468,075$742,158
APCM net reimbursement$178,797$230,151$408,948
Total net reimbursement$744,799$1,449,409$2,194,208
CoachCare fees (incl. one-time)$433,155$828,885$1,262,040
Net to the health center$311,644$620,524$932,168
Margin to the health center41.84%42.81%42.48%
The on-site enrollment specialist is staffed at CoachCare's expense and is already inside the fees above — never a separate cost to the health center. Run the model without any enrollment specialist and 24-month net reimbursement falls by $478,878.
71

Hospitalizations Avoided

Roughly $1.07 million of avoided acute cost over 24 months. That value accrues to payers and to the ACO's total-cost result rather than to MedCura's revenue line, so it is excluded from every figure above.

112,143

Readings Captured

Blood pressure, weight and glucose readings arriving between visits — where the hypertension and diabetes measures are decided.

33,680

Claims Generated

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

14,562

Care-Team Hours Delivered

About 7.0 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 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 panel slider is the strongest lever in the model.
24-mo net reimbursement
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Net to the health center
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Active enrollments · M24
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Unique patients · M24
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Hospitalizations avoided
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Scope

Medicare Is 8% of the Panel — and the Rail That Pays Today

The forecast above covers 2,935 Medicare and dual-eligible patients. MedCura serves 36,741 — including 14,542 with Medicaid. Georgia Medicaid does not reimburse remote monitoring or care management as separate services for health centers, so this plan books zero Medicaid revenue and assumes nothing changes.

The Georgia baseline

Fee-for-service Medicaid is not the rail

The state's telehealth guidance authorizes health centers as originating and distant sites for visits — it does not pay the RPM or CCM code families. Managed-care plan policies vary by contract and belong in a contracting conversation, not a forecast.

Why Medicare first

Federal, national-rate, self-funding

Medicare pays the same national amount at every site, funds itself from month two, and is the one rail where between-visit work is reimbursed today. Within the 2,935, Medicare Advantage — the majority choice in DeKalb County — must pay at least 100% of the Medicare rate, and each plan's contract sets its own terms for these code families; the payer split is the first number to confirm.

The all-payer flywheel

The same protocols serve everyone

The UDS measures are all-payer. The blood-pressure pathways, escalation engine and multilingual staff the Medicare line funds are the same ones every MedCura patient encounters — and quality movement shows up in HRSA reporting and the ACO gate either way.

The sequencing this implies. Build the Medicare service line first: it is federal, it pays the same rate at all sixteen sites, and it is margin-positive from month two. Every extension beyond it — Medicaid managed care, grant-funded cohorts, employer contracts — inherits a running program instead of a pilot.
Getting Started

Live in 30 Days

Week 1

Confirm the panel and the payer split

Pull the exact Medicare count and the fee-for-service vs Medicare Advantage split from athenaOne, agree which sites start, and set the escalation contacts.

Weeks 2–3

Build the athenahealth integration and configure

Enrollment flags and trigger orders in the existing workflow, discrete vitals mapped to the chart, escalation routing set to MedCura's own team — with sequencing for the three eastside sites completing their move onto the enterprise system.

Week 4

First patients enrolled

Enrollment begins in month one — there is no dormant onboarding period. Outreach runs in Spanish, French and the panel's African dialects from the first call.

Months 2–16

Full eligible population enrolled

APCM reaches its ceiling in month 6, CCM in month 10 and RPM in month 16. From there the program grows with the panel itself — including the eastside patients the Whitefoord merger brought in.

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.