Focused Care for High-Risk Conditions
Intensive management for patients with a single high-risk chronic condition requiring substantial care coordination
What is Principal Care Management?
Principal Care Management (PCM) provides comprehensive care coordination for patients with a single high-risk chronic condition that places them at significant risk of hospitalization, acute exacerbation, or functional decline.
Unlike CCM which requires multiple chronic conditions, PCM focuses intensive resources on managing one complex condition that requires substantial care coordination and ongoing monitoring.
Qualifying Conditions
- Advanced heart failure
- Severe COPD requiring oxygen therapy
- Advanced kidney disease (Stage 4-5 CKD)
- Complex diabetes with complications
PCM vs CCM: Key Differences
Principal Care Management
- Single high-risk chronic condition
- Intensive care coordination required
- Minimum 30 minutes per month
- Higher reimbursement rate
Chronic Care Management
- Two or more chronic conditions
- Comprehensive care coordination
- Minimum 20 minutes per month
- Standard reimbursement rate
PCM Services
Intensive Monitoring
Frequent assessment of symptoms, vital signs, and disease progression with immediate intervention when needed.
Specialist Coordination
Seamless coordination with specialists, ensuring all providers work together toward optimal outcomes.
Hospitalization Prevention
Proactive interventions to prevent acute exacerbations and reduce emergency department visits.
Implement PCM Services
Provide intensive care management for your highest-risk patients