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Cohort: Full-service Chronic Care Management

Cohort: Full-service Chronic Care Management

Chronic Care Management


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1 - 10 practices use this product.

Cohort partners with practices to eliminate care gaps with insight, experience, and compassion. Our full-service Chronic Care Management (CCM) solution serves as the foundation for successful Value Based Care by delivering best-in-class patient identification, enrollment and engagement.

Cohort utilizes Artificial Intelligence and Natural Language Processing (NLP) to correlate and reconcile insights from unstructured Clinical notes, Medications, Lab/Diagnostics to provide Care Managers greater context and insight into their patients and process, enabling your team to care for the right patient at the right time.

Most CCM implementations fail to meet the practice’s expectations due to significant issues around patient identification, managing a new enrollment workstream with associated costs and overhead, and delivering consistent and empathy-driven conversations with patients. The Cohort team has worked together previously to drive leading solutions across the Healthcare landscape, including AI/NLP, Clinical Intelligence, Care Management Services, Clinical Trials/CROs, and Discharge Planning. We have successfully implemented clinical workflows in over 750 hospitals and health systems, as well as a large number of independent and regional providers. Cohort’s veteran and proven team has developed a comprehensive service model to maximize program efficiency and data accuracy.

  • Automated identification of eligible patients, care gaps and relevant conditions
  • Higher enrollment through proven workflows
  • Consistent patient engagement and personalized care plans
  • Comprehensive compliance and audit tracking with Medicare requirements
  • Automated billing reconciliation with 96% paid claims
  • NO upfront cost, additional staff, or overhead
  • Comprehensive Care Plans with metrics accessible by entire care team
  • Enabled and accelerated Clinical Trial recruitment
  • Hybrid model can leverage your existing Care Managers
  • Significantly reduce time to review patient records in the EHR

We are passionate about leveraging our collective experience to provide leading technology and services to improve patient outcomes. We look forward to working with you.

Contact us: info@cohort.ai

Chronic Care Management, Care Coordination, Care Plan Management
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