As healthcare providers face growing pressure to improve patient outcomes, meet value-based care goals, reduce operational costs, and implement new revenue streams, outsourced care management has emerged as a strategic and practical solution. What makes outsourcing so worthwhile?
The clinical and financial benefits are clear. By partnering with experienced care management organizations, providers can access scalable, compliant, and cost-effective programs that support chronic disease management, promote patient health, reduce the need for in-person visits, lower emergency room utilization and hospital readmissions, and free up internal staff to focus on in-office care. Whether for a solo practice or a large health system, outsourcing some or all care management responsibilities is a sound consideration.
Let's explore why care management programs like remote patient monitoring (RPM), chronic care management (CCM), and advanced primary care management (APCM) are ideal candidates for outsourcing, followed by a checklist providers can follow to help them select the right long-term partner.
Remote Patient Monitoring (RPM): Simplifying a High-Touch, Tech-Driven Service
Remote patient monitoring is a data-driven service that enables providers to remotely track patients' vitals and health status using connected devices. But implementing an in-house RPM program can be resource-intensive. It requires clinical staffing, technical setup, patient onboarding, device logistics, and ongoing monitoring. Outsourced RPM services streamline this process by providing end-to-end management, including device shipping, data review, and clinical escalation protocols. With the right partner, providers can realize the revenue potential of RPM without sacrificing time or compliance.
Chronic Care Management (CCM): Streamlining a Complex Service
Chronic care management programs offer monthly support to patients with two or more chronic conditions. The administrative and documentation requirements can be a barrier to in-house implementation. Outsourced CCM services deliver these benefits without a significant internal burden. Qualified care managers handle outreach, personalized care planning, time tracking, and compliant CCM coding and billing. At the same time, outsourcing chronic care management can lead to improved clinical outcomes and enable providers to focus on in-office care, while ensuring patients receive coordinated, proactive support between visits.
Advanced Primary Care Management: Maximizing Impact Through Expertise
Advanced primary care management is a new Medicare program that was launched in 2025. APCM is designed to be a structured, continuous service tailored to Medicare beneficiaries across the complexity spectrum, from those with minimal chronic needs to high-complexity, QMB-designated individuals. Available exclusively to primary care providers, APCM allows monthly billing based on patient complexity and emphasizes proactive, personalized care that fosters patient engagement, adherence, and early intervention. Services may include behavioral health support, transitional care, and social determinants of health (SDOH) interventions, delivered by interdisciplinary teams such as nurses and care coordinators.
Implementing APCM successfully requires clinical expertise, integrated workflows, and compliance to its new coding and billing guidelines and service elements. By outsourcing APCM, providers can more easily add the service by entrusting it to skilled teams knowledgeable in the rules without the burden of building in-house infrastructure.
The Care Management Outsourcing Checklist: 10 Non-Negotiables
Not all care management service vendors are created equal. Whether you're outsourcing RPM, CCM, APCM, or all three, this checklist will help you evaluate potential partners to ensure long-term success.
1. General care management expertise
Look for a vendor with a proven track record across multiple care management services, patient populations, and chronic diseases. They should employ staff with knowledge and experience in chronic disease management, care coordination, and personalized care delivery.
2. Covered services: RPM, CCM, and APCM
You need a vendor that can support the specific care management service you are looking to outsource. However, it is especially advantageous to partner with an organization that offers integrated support for core remote care services — RPM, CCM, and the newly introduced APCM — under one roof. This capability allows you to build a more comprehensive, scalable care management program that promotes continuity, reduces vendor fragmentation, streamlines oversight and communication, and enables efficient expansion without starting from scratch for each new service.
3. Care management coding and billing knowledge
Reimbursement for care management is nuanced and requires accurate time tracking, use of proper CPT and HCPCS codes, and comprehensive documentation. Your partner should be well-versed in billing guidelines to ensure claims are clean, defensible, and optimized to ensure appropriate, timely reimbursement.
4. Emphasis on compliance
The likes of HIPAA compliance and CMS regulatory adherence should be built into every aspect of the vendor's operations — from data security to patient consent workflows. Look for clear policies, audit-ready processes, and ongoing staff training as part of the vendor's compliance culture.
5. Flexible engagement model
The ideal partner can and is willing to adapt to your needs, whether you are seeking a fully outsourced care management model or supplemental support for your internal team. Flexibility in staffing, documentation preferences, and communication style helps ensure a more seamless fit with your practice.
6. Efficient and effective program scalability
A care management program that works for 100 patients should also work for 1,000 or more. The vendor should have the staffing, infrastructure, and technology to scale without sacrificing service quality, responsiveness, or performance.
7. Transparency and reporting
Visibility into performance metrics — such as patient engagement, time spent, and health outcomes — is critical to maintain trust and accountability. Your vendor should deliver clear, regular reporting and real-time metrics to give you confidence that your program is performing effectively and that patients are receiving meaningful, impactful care management services.
8. Access to partner’s software
Though outsourcing removes the need for practice staff to monitor incoming data, clinical staff should have access to the outsourced vendor's platform. This access ensures transparency into care manager activity and enables providers to retrieve patient health data when necessary. Unlike many outsourcing models that operate in closed systems with limited practice visibility, more collaborative approaches use the same care management platform as the practice itself. This shared environment fosters accountability and gives practices full oversight of outsourced operations.
9. Integration with existing systems
Disconnected systems create inefficiencies and raise risks. The right partner should offer integration with your EHR and workflows or provide care managers who can document directly in your system to reduce duplication and save staff time.
10. Ease of communication and access to support
Timely communication can make or break a care management partnership. Choose a vendor that offers dedicated account management, accessible support channels, and open lines of communication with care managers and, when necessary, leadership.
Want More Information About Outsourced Care Management? Ready to Get Started?
This checklist is designed to support your research into outsourced care management providers. For a deeper dive into outsourcing strategies and key vendor considerations, download our guide: "How to Scale Remote Care Management Programs: Provider's Quick Guide to Outsourcing Support."
If you're ready to take the first steps toward outsourcing your care management services, contact Prevounce today. Whether you are just getting started or looking to scale, Prevounce offers flexible, scalable outsourced care management services across RPM, CCM, and APCM. Our expert care teams, compliant workflows, and seamless integrations enable providers to launch and scale effective, revenue-generating care management programs without adding significant overhead. We would welcome the opportunity to tell you all about how outsourcing part or all of your care management services to our team can help you grow, improve outcomes, and stay focused on delivering high-quality patient care.