Prepared for Cardiovascular Consultants, P.C. · 2026 Strategy Review · Confidential — not for distribution
Cardiovascular Service Line Performance & Optimization · Munster · Hammond · Crown Point

Margin-Positive Before Any
Value-Based Dollar.

How Northwest Indiana's independent cardiology group converts the Medicare panel it already manages — heart failure, coronary artery disease, atrial fibrillation, and hypertension — into a continuously monitored remote care service line with recurring reimbursement, powered by CoachCare.

$0
24-Month Net Reimbursement
$0
24-Month Practice Margin
0
Hospitalizations Avoided
0
Unique Patients in Active Remote Care (Month 24)
Independent · Full-Spectrum · Built Out — Except One Layer

2026 Starts From a Position of Strength

Cardiovascular Consultants is not missing capabilities — it already runs nearly every piece of a modern cardiovascular practice. Seven cardiologists and three advanced practice providers cover interventional, structural-heart evaluation, diagnostics, and chronic cardiac clinics across three offices and seven satellite communities. What the public footprint shows no trace of is the one layer Medicare now pays for month after month: a chronic remote care program.

✓ In place

Full-Spectrum Cardiology

Interventional coronary, peripheral, and carotid work; left atrial appendage (LAA) closure procedures; evaluation for TAVR and mitral clip — the procedural franchise is already built.

✓ In place

Connected Diagnostics Today

Holter and mobile cardiac telemetry, echo, vascular and nuclear imaging, pacemaker/defibrillator checks — the practice already consumes device data every day. The chronic monitoring layer is the natural extension.

✓ In place

Chronic Cardiac Clinics

A coumadin management clinic and a lipid clinic — standing longitudinal programs whose patients are exactly the RPM and PCM enrollment funnel.

✓ Verified

Digital Front Door Live

The FollowMyHealth patient portal — a Veradigm product — is already in patients' hands, corroborating the practice's Veradigm EMR environment. Patients are already digital; monitoring is the next step.

Three offices — Munster, Hammond, Crown Point — plus satellite reach into DeMotte, Dyer, East Chicago, Lake Station, Portage, Whiting, and Winfield. And in that entire footprint, no remote patient monitoring, chronic care management, or principal care management program is marketed anywhere today. That whitespace is the opportunity on this page.

The 2026 Window

Why 2026 Is the Year to Build It

Three forces converge this year: Medicare's remote-care billing framework just got broader, readmissions still carry real financial consequences for the hospitals that depend on this practice, and — unusually — there is no downside clock running. The timing is pure upside.

CY2026 Tailwind
99445 · 99470

Short-Window RPM Is Now Billable

New CY2026 codes 99445 (2–15-day device supply) and 99470 (first 10 minutes of management) remove the 16-day floor that previously blocked episodic monitoring — making post-procedure recovery windows after LAA-closure and other interventions cleanly billable for the first time.

Referral Defense
30 Days

Readmissions Still Carry a Price

Medicare's readmission penalty program still bites the area hospitals this practice works with every day. The cardiology group whose heart failure patients don't bounce back inside 30 days becomes the group every discharge planner wants on the chart — a referral-relationship asset no competitor in the market currently holds.

$0 at Risk

No Downside Clock

The practice carries no mandatory model exposure — pure-upside timing, and prepared if selection maps change. Every dollar in the forecast below is fee-for-service reimbursement for care the practice controls, with nothing owed back to CMS under any scenario.

Heart Failure
Coronary Artery Disease
Atrial Fibrillation
Hypertension
The Operating Model

One Service Line, Powered by an Engine You Don't Have to Build

Not a point solution bolted onto one condition — a named service line with its own P&L, following the cardiac patient from discharge to long-term stability. The practice already runs connected-monitoring workflows for Holter and device checks; this is the partner model that adds the chronic layer without adding headcount.

The Clinical Stack — TCM → RPM → PCM
  • TCM Structured 30-day post-discharge management (99495/99496) — the billable bridge from the hospital to the clinic for heart failure and post-procedure patients.
  • RPM Device-based physiologic monitoring (weight, blood pressure, pulse ox) — the continuous early-warning and GDMT-titration layer across the HF, CAD, AFib, and hypertension panels.
  • PCM Principal Care Management (99426/99427) — the care-management wrapper for the condition this practice actually owns: resistant hypertension, coronary disease, heart failure, or cardiovascular disease as a single domain.
The Engine — Operated by CoachCare
  • Enroll An on-site enrollment specialist — staffed at CoachCare's expense — plus physician-referral and telephonic outreach pathways.
  • Monitor Cellular devices shipped and supported; 24/7 alert triage; clinical monitoring staff handling readings, outreach, and documentation.
  • Document Time-stamped, audit-ready care logs flowing into the practice's Veradigm environment.
  • Bill Claims-ready output for every eligible patient, every month — the practice bills, the practice keeps the margin.
Why PCM, not CCM: a specialist's care management is focused on one principal condition — resistant hypertension, coronary disease, heart failure — or on cardiovascular disease as a single domain, which is precisely what Principal Care Management is written for. Chronic Care Management assumes management of all of a patient's conditions, and it is increasingly billed by the patient's primary care practice, or absorbed into a prospective payment there. PCM is the code that fits the specialist's actual scope and does not collide with the PCP's.
The one coordination rule: each patient gets one longitudinal care-management wrapper — PCM on the principal cardiac condition — while RPM stacks with it and TCM owns the 30 days after every discharge. One enrollment decision per patient, set in protocol.

The CY2026 Billing Stack — Priced for Munster

ServiceCodesCY2026 Rate (IN Locality)Cardiovascular Use
Transitional Care Management99495 · 99496~$200 / ~$280*Every HF and post-procedure discharge
RPM device supply99454 · 99445 (new)$48.15/mo99445 unlocks 2–15-day post-procedure windows*
RPM treatment management99457 · 99458 · 99470 (new)$48.89 + $39.29 add'lMonthly review, GDMT titration, escalation
Principal Care Management99426 · 99427$64.26 + $51.15 add'lThe principal cardiac condition — HF, CAD, resistant HTN — ≥3 months

Dollar rates are CY2026 Medicare values for the Indiana statewide locality (zip 46321 — Munster is priced at Indiana rates, not Chicago's). *Asterisked figures are illustrative national magnitudes for codes outside the modeled economics; TCM and the new 2026 codes are not in the forecast below — they are upside on top of it. Verify all rates against the current Physician Fee Schedule.

One Build, Four Returns

The Value Layers, In Order

The forecast below stands on its own P&L — everything after the first layer is additional return on infrastructure the service line has already paid for.

1 · A Standalone Recurring P&L
The lead story is the simplest one: $2.28M in modeled 24-month net reimbursement, $971,484 of practice margin after all CoachCare fees, at a 42.6% margin — recurring, subscription-like revenue from the panel the practice already manages, margin-positive from month two, with no negative-margin quarter. Illustrative, modeled — verify against practice data. No value-based contract required.
2 · Avoided Cost & Referral Defense
~113 modeled hospitalizations avoided over 24 months — roughly $1.70M in acute-care cost at $15K per admission. Illustrative, modeled — verify against practice data. Continuous HF surveillance is what keeps patients out of the 30-day window that readmission penalties still price for area hospitals — making this practice the discharge-referral partner of choice against employed and competing groups.
3 · Procedural Throughput
Remote recovery surveillance supports earlier, confident discharge after LAA-closure procedures and keeps the TAVR- and mitral-clip-evaluation funnel warm and monitored between visits — protecting and growing the procedural franchise that anchors the practice.
4 · Modernized Clinics as Enrollment Funnels
The Holter/MCT service, the pacemaker/defibrillator check clinic, and the coumadin clinic are ready-made enrollment funnels: patients already sending the practice data episodically convert naturally to continuous RPM, and INR-managed patients are a documented chronic-management population from day of consent.
5 · The Hypertension & RDN Whitespace
A resistant-hypertension RPM panel is the substrate for renal denervation readiness — structured BP monitoring identifies and documents the refractory patients who become RDN evaluation candidates as coverage matures. No group in the market visibly runs this panel today; the first mover owns the funnel.
In the System You Already Use

Integrated With Your Veradigm Environment

The practice's Veradigm EMR — already corroborated by the FollowMyHealth patient portal your patients use today — is a supported CoachCare integration. Enrollment, vitals, documentation, and billing-ready output flow between the two systems so the program lives where your clinicians already work. The exact Veradigm product configuration is confirmed in contracting, and the integration's setup and maintenance costs are already inside the fee lines of the forecast below.

Veradigm The practice's EMR environment One chart, one workflow Orders & enrollment flags Vitals & care documentation FollowMyHealth portal Billing workflow CoachCare Remote care platform Cellular devices 24/7 monitoring Health coaches Enrollment team Billing engine FROM VERADIGM Enrollment flags & candidate lists Patient health history BACK INTO VERADIGM Discrete vitals — data, not PDFs Care summary & compliance documentation Real-time enrollment status Claims-ready billing output, every patient, every month Clinicians stay in their own workflow — the program lives alongside the chart they already use

Already in the model

Veradigm integration setup and monthly maintenance are inside the month-1 economics and the fee lines of the forecast — no hidden IT project.

Confirmed in contracting

The integration is scoped to the practice's exact Veradigm product during contracting — a configuration step, not a discovery risk.

CoachCare Value Analysis · Modeled for Cardiovascular Consultants, P.C.

The Value Analysis

A 24-month forecast built on this practice's own parameters: an estimated ~4,000-patient Medicare panel, 10 referring providers, one on-site enrollment specialist, Veradigm integration, and CY2026 Medicare rates auto-resolved for zip 46321 (Indiana statewide locality). The service line is RPM + PCM — physiologic monitoring plus Principal Care Management on the principal cardiac condition. Avoided-readmission savings, TCM, and the new 2026 short-window codes are not in these numbers — they are upside on top. All figures are illustrative, modeled — verify against practice data.

Active Program Enrollments Under Remote Care

Monthly active enrollments by program — not unique patients; a patient carrying both RPM and PCM is counted in each. Physician referrals (5/provider/mo, 70% acceptance) + 1 on-site enrollment specialist (80/mo) + telephonic outreach, net of discharges · RPM caps at 1,050 (M16); PCM runs to ~677 of a 1,020 ceiling by month 24. Illustrative, modeled — verify against practice data.

Monthly Economics — Revenue, Fees, Margin

Net reimbursement (after denials and coinsurance bad debt) vs. CoachCare fees · month 1 carries one-time implementation and Veradigm integration setup (−$3,559); margin turns positive in month two and there is no negative-margin quarter. Illustrative, modeled — verify against practice data.

24-Month Net Reimbursement Mix

$2.28M total across the RPM + PCM cardiology stack. Illustrative, modeled — verify against practice data.

The Financial Summary

24-month, by programNet reimb.CoachCare feesPractice margin
RPM$1,557,755$873,485$684,270
PCM$720,575$374,783$345,792
Implementation & ancillary$58,578−$58,578
Total, 24 months$2,278,330$1,306,846$971,484
By periodNet reimb.CoachCare feesPractice margin
Year 1$616,896$360,654$256,242
Year 2$1,661,434$946,192$715,242
24 months$2,278,330$1,306,846$971,484
Includes an on-site enrollment specialist staffed at CoachCare's expense — embedded value, never subtracted from practice margin.

24-month practice margin: 42.6% of net reimbursement (Year 1 41.5%, Year 2 43.0%). Figures are illustrative, modeled — verify against practice data. Full model available as a companion workbook. "Active enrollments" counts program enrollments, not unique patients — dual-enrolled patients appear in each program they join; the headline patient figure of 1,253 is deduped.

Scenario Explorer — Build Your Own Forecast

Adjust the assumptions and watch the 24-month forecast recompute live. Calibrated to the CoachCare Value Analysis engine — at the modeled defaults it reproduces the workbook — but the companion workbook remains the source of truth. Census is active program enrollments, not unique patients. Illustrative, modeled — verify against practice data.
24-mo net reimbursement
$2.28M
24-mo practice margin
$0.97M
Active enrollments at month 24
1,727
Hospitalizations avoided
~113
44,636

Billed Claims / Units

Recurring, subscription-like professional-fee volume over 24 months. Illustrative, modeled — verify against practice data.

178,496

Physiologic Readings

A continuous clinical picture of the HF, CAD, AFib, and hypertension panels between visits. Illustrative, modeled — verify against practice data.

~113

Hospitalizations Avoided

≈ $1.70M in avoided acute-care cost at $15K per admission — and 30-day readmission relief for hospital partners. Illustrative, modeled — verify against practice data.

10.0

FTE-Years Absorbed

~20,894 care-team hours of monitoring, outreach, and documentation handled by CoachCare's clinical staff. Illustrative, modeled — verify against practice data.

Implementation

Chartered in 30 Days.
Piloting by Day 90.

CoachCare operates as the service line's engine — enrollment outreach, device logistics, 24/7 monitoring, and billing-ready documentation — while Cardiovascular Consultants' physicians govern protocols and every clinical decision. Full-service delivery means launch requires no new practice headcount: the on-site enrollment specialist is CoachCare's hire, and the monitoring load lands on CoachCare's clinical staff, not the practice's medical assistants.

Schedule the Working Session
0–30 Days

Charter the Service Line

Named physician champion and P&L; Veradigm integration and billing configuration; PCM principal-condition documentation policy set in protocol; pathway sign-off for HF, CAD, AFib, and hypertension.

31–90 Days

Pilot: Two Anchor Cohorts

Heart failure post-discharge patients and the coumadin/device-clinic panels — the populations already known, already engaged, already generating data.

91–180 Days

Scale Across All Three Offices

Munster, Hammond, and Crown Point all enrolling; post-procedure recovery monitoring live for the interventional and LAA-closure caseload; monthly service-line scorecard in place.

181–365 Days

Extend the Reach

Resistant-hypertension RPM panel building the renal-denervation-readiness funnel; enrollment outreach extended through the seven satellite communities — remote care follows the patients the satellites already serve.

The Proving Ground

Pilot It Where Everything Converges: Munster

The Munster headquarters is the natural pilot site — the practice's highest-volume office, on the campus of its primary hospital partner, steps from where the highest-acuity discharges happen. The coumadin clinic, the device-check clinic, and the physicians who round on those inpatients all work from the same building.

A Munster-first launch concentrates enrollment where discharge volume already flows, lets one office's physicians and staff shake out the workflow, and produces the internal evidence — census, capture rate, revenue per patient-month, readmission signal — that makes the practice-wide rollout a data decision, not a leap.

Scale path: Munster proves it → Hammond and Crown Point join in the second wave → enrollment outreach extends through the satellite communities. Same protocols, same Veradigm configuration, zero re-implementation.

The 90-Day Munster Pilot

Two anchor cohorts: HF post-discharge patients, plus the coumadin and device-clinic panels
MilestoneTarget
Veradigm integration + protocol sign-offDay 30
First billable enrollmentsDay 30–45
48-hour post-discharge outreach rate≥ 90%
7-day post-discharge follow-up rate≥ 70%
Active remote-care enrollments by Day 90*~177
Go / scale decision with full unit economicsDay 90

*The modeled months 1–3 practice-wide enrollment ramp (36 → 95 → 177 active program enrollments), concentrated at the pilot office during the Munster-first phase. Illustrative — the pilot's actual funnel is set in protocol design.

About CoachCare

The Experience to Get It Right

The service line described on this page runs on infrastructure already proven at national scale.

500,000+

Patient Management Expertise

Over 400 managed conditions for 500,000+ patients.

10,000+

Clinician Success

Providers committed to remote care excellence.

1,000+

In-Market Success

Successful program implementations.

5M+

Operational Excellence

Care plan coding and billing generating over 5 million claims.

100M+

Unprecedented Scale

Over 100 million vitals recorded and 4 million+ care actions enabled.

Transparency

Assumptions & Sources

Every number on this page traces to the CoachCare Value Analysis workbook or cited public data. The key assumptions:

Population sizing & enrollment mechanics
  • ~4,000 Medicare patients estimated for the practice (range 3,600–4,130). Two independent methods agree: practice-level Medicare allowed charges of ~$5.37M ÷ ~$1,300 per cardiology beneficiary-year ≈ 4,128, and a provider-based cross-check of 7 physicians × ~800 unique Medicare beneficiaries × 70% deduplication ≈ 3,920. This is a modeling estimate, not a chart count — validate against practice chart counts in discovery.
  • Full panel of 4,000 in scope from Year 1. Cardiology eligibility: 75% for RPM (3,000 patients) and 85% for PCM (3,400 patients). Acceptance: 35% for RPM and 30% for PCM — yielding enrollment ceilings of 1,050 (RPM, reached month 16) and 1,020 (PCM, not reached in 24 months; ~677 active at month 24).
  • The service line models RPM + PCM only. Principal Care Management (99426/99427) is the care-management code for a specialist: a cardiologist's care management is focused on one principal condition — resistant hypertension, coronary disease, heart failure — or on cardiovascular disease as a single domain, which is precisely what PCM is written for. Chronic Care Management assumes management of all of a patient's conditions, and it is increasingly billed by the patient's primary care practice, or absorbed into a prospective payment there. PCM is the code that fits this practice's actual scope and does not collide with the PCP's.
  • Enrollment pathways: physician referral (5 referrals/provider/month across 10 providers at 70% acceptance), one on-site enrollment specialist at 80 enrollments/month staffed at CoachCare's expense, and telephonic outreach.
  • "Active program enrollments" (1,727 at month 24) is the sum of per-program enrollments, not unique patients — a patient carrying both RPM and PCM is counted in each. The headline patient figure, 1,253 unique patients at month 24, is deduped for that overlap (~70% dual-enrollment assumed).
Rates & revenue mechanics
  • CY2026 Physician Fee Schedule rates auto-resolved by Medicare carrier/locality for zip 46321 — the Indiana statewide locality (Munster is priced at Indiana rates, not Chicago's). Key rates: 99457 $48.89, 99458 $39.29, 99454 $48.15, 99426 $64.26, 99427 $51.15.
  • 2.5% denial rate; 20% coinsurance with 25% coinsurance bad debt; 1.5% monthly attrition. Code-level capture assumptions (e.g., share of managed months billing 99457 or adding a 99458 unit) are itemized in the companion Value Analysis workbook.
  • Month 1 is modestly negative (−$3,559): one-time implementation and Veradigm integration setup land ahead of the enrollment ramp. Margin turns positive in month two (+$3,683) and stays positive every month thereafter — there is no negative-margin quarter. 24-month practice margin is 42.6% of net reimbursement.
  • Hospitalizations avoided (≈113 over 24 months) are modeled from RPM patient-months and valued at an illustrative $15,000 per admission.
  • TCM (99495/99496), the new CY2026 short-window RPM codes (99445/99470), and avoided-readmission savings are excluded from the modeled totals — upside on top.
  • The Scenario Explorer above runs the same enrollment engine as the workbook; at the modeled slider defaults it reproduces the workbook's 24-month net reimbursement, fees, margin, and month-24 enrollment to within 0.05%.
Practice & market facts (verified July 2026)
  • Practice profile from cardioconsultantspc.com, reviewed July 2026: 7 cardiologists + 3 advanced practice providers; offices in Munster, Hammond, and Crown Point with satellite reach into DeMotte, Dyer, East Chicago, Lake Station, Portage, Whiting, and Winfield; services include interventional cardiology, LAA-closure procedures, TAVR and mitral clip evaluation, Holter/mobile cardiac telemetry, pacemaker/defibrillator checks, coumadin and lipid clinics, and vein/PAD care.
  • EMR: Veradigm, confirmed via vendor-intelligence crawl and corroborated by the practice's FollowMyHealth patient portal (a Veradigm product). The exact Veradigm product configuration is confirmed in contracting.
  • No remote patient monitoring, chronic care management, or principal care management program is marketed anywhere on the practice's public footprint — confirm current internal programs in discovery.
  • Indiana Medicare context: roughly half of the state's ~1.4M Medicare beneficiaries are in Medicare Advantage (early 2026), leaving a substantial Traditional-Medicare population for fee-for-service care-management billing; validate the practice's own payer mix in discovery.