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Chronic Care Management

The Chronic Care Management (CCM) program is a care coordination service that is completed outside of your regular visits with your healthcare provider. This program provides you with around-the-clock access to care that will help you stay on track with your treatments and overall care plan. Offered to Medicare patients with little to no cost. With CCM:

  • An interdisciplinary team of professionals including the provider, nurses, outpatient services, a social worker, case management, addresses the physical and social needs by coordinating care.
  • Nurses make routine calls to patients and their families to see if any new symptoms or needs arise and relay this information to their primary provider. 
  • If symptoms or pain are unmanageable at home, they may be admitted as an inpatient to the hospital, placed on observation status, swing bed, or admitted to a nursing home. Further guidance from the Physicians Clinic, Walk-in Clinic, or ER are needed.


If you live with two or more chronic conditions, CCM can help you manage your care. Some examples of chronic conditions include, but are not limited to:

  • Alzheimer's & related dementia
  • Arthritis
  • Cancer
  • COPD
  • Diabetes
  • Heart Failure
  • Osteoporosis
  • And more

Additional support provided includes:

  • 24/7 support
  • Patient education
  • Transportation for SRMC established patients in need to attend clinic and outpatient service visits at SRMC

Click to learn more about Chronic Care Management.

For more information or question on CCM, call the SRMC Physicians Clinic at 308.254.5544.