Comprehensive Care Management


Personalized Support for Patients with Chronic Conditions

Comprehensive Care Management (CCM) at Oak Medical

Comprehensive Care Management (CCM) is designed to improve care coordination for patients with chronic conditions. Our RN program offers structured, ongoing support to ensure patients receive the comprehensive care they need between visits, reducing hospital readmissions and enhancing their quality of life.

What is Comprehensive Care Management?

Access to 24/7 Clinical Support Team

In-between visit management of chronic conditions

Continuous monitoring of medication adherence

Ongoing assessment of symptom changes

Individualized support for better patient engagement

Assure patients remain stable and well supported in-between visits

Tailored strategies to meet individual patient needs

Examples of Conditions that CCM Supports

Diabetes

Hypertension

Heart Failure

Alzheimer’s or Dementia

COPD & Chronic Respiratory Diseases

Arthritis & Chronic Pain Conditions

Chronic Kidney Disease

Benefits

Overall improvement in patient’s quality of life

Improved access to care team

Increased patient satisfaction

Reduced ER visits and hospitalizations

Care coordination with specialists and families

Patient-Centric Model

Our systems are designed to keep the patient experience at the center while streamlining operations for facilities. Offering a single touchpoint for patients, their families, and facility staff saves time, enhances communication, and positively impacts care by removing obstacles.