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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
The population where these codes bill at Medicare rates — MedCura's 2,716 plus the 219 who arrived with Whitefoord this year.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Bi-directional at intake, so the care team starts with the same problem list, medications and history the clinic has.
Blood pressure, weight and glucose readings post as structured data on the patient record rather than as attachments nobody opens.
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.
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.
The economics prove the service line pays. This is what keeps it safe — and what lets 16 busy clinicians delegate monitoring without inheriting noise.
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.
A patient who feels fine with a critical reading still escalates. Feeling well is not a reason to wait.
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.
Voicemail and a callback attempt are logged, and a critical value or confirmed trend escalates anyway. Silence never closes a case.
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.
Vital, findings, method of contact, who was reached, outcome, and follow-up. That record is also what substantiates the billed time.
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.
| Program | Year 1 | Year 2 | 24‑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 center | 41.84% | 42.81% | 42.48% |
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.
Blood pressure, weight and glucose readings arriving between visits — where the hypertension and diabetes measures are decided.
Coded, documented and submitted with the time capture the CY2026 individual-code rules require.
About 7.0 full-time equivalents of care-management capacity, added without the health center hiring anyone.
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 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.
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 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.
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.
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.
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.
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.
Over 400 managed conditions.
Providers running remote care programs day to day.
Programs stood up and running in market.
Care-plan coding and billing behind more than five million claims.
Over 100 million vitals recorded and more than 4 million care actions enabled.