Prepared for Heart & Vascular Center of West Tennessee · 2026 Strategy Review · Confidential — not for distribution
Cardiovascular Service Line Performance & Optimization · Jackson, Tennessee

Margin-Positive Before Any Value-Based Dollar —
and Model-Ready if Selection Maps Change.

How the Heart & Vascular Center of West Tennessee converts a five-site rural cardiology franchise into continuous care for heart failure, coronary artery disease, atrial fibrillation, and hypertension — as a recurring, margin-positive service line that stands on its own P&L.

$0
24-Month Net Reimbursement
$0
24-Month Practice Margin
0
Hospitalizations Avoided
0
Active Program Enrollments at Month 24
Independent · Physician-Owned · Five Sites Deep

2026 Starts From What You've Already Built

This is not a turnaround story. The Heart & Vascular Center of West Tennessee is the region's independent, physician-owned cardiovascular practice — six cardiologists and eight advanced-practice providers covering five communities that larger systems reach only from a distance. The strategic question is how to monetize the care that already happens between visits, before any payment model requires it.

✓ In place

Full-Spectrum Cardiology

Interventional cardiology, electrophysiology, WATCHMAN left-atrial-appendage closure, vascular lab, external counterpulsation, and active clinical trials — in an independent practice.

✓ In place

ACR-Accredited Advanced Imaging

Cardiac PET/CT and nuclear imaging accredited by the American College of Radiology — diagnostic depth most independent groups outsource.

✓ In place

Five-Site Rural Footprint

Jackson hub plus Lexington, Dyersburg, McKenzie, and Ripley — a hub-and-spoke network that puts a cardiologist within reach of deeply rural West Tennessee.

✓ Precedent

Partner-Model DNA

The practice already outsources remote device monitoring for pacemakers and ICDs to a specialist partner — proof that buy-over-build works here when the economics are right.

One more structural advantage: since October 2025 the practice runs on Epic, with MyChart live for patients, through its hospital partner's instance — one chart, one in-basket, one billing layer. That is precisely the substrate a remote care service line needs. What's missing is the service line itself: no RPM, CCM, or PCM program is marketed anywhere in the practice today.

The 2026 Window

Why This Year, Why This Practice

Three things converge in 2026: a billing change that finally fits cardiology's clinical windows, readmission economics that your hospital partners feel every year, and a timing position most cardiology groups would envy.

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) make post-procedure and transitional monitoring windows cleanly billable — removing the 16-day floor that previously blocked episodic remote care after WATCHMAN, interventional, and EP procedures.

Every Year
HRRP

Readmissions Still Cost Your Partners

Heart-failure readmission penalties bite the hospitals your patients discharge from — Jackson-Madison County General and Dyersburg among them. A practice that demonstrably keeps discharged cardiac patients out of the hospital becomes the referral partner every case manager calls first.

Pure Upside

Build on Your Own Terms

No mandatory model exposure — pure-upside timing, and prepared if selection maps change. Every dollar in this analysis is fee-for-service revenue the practice earns directly, starting now, with no downside risk attached.

Heart Failure
Coronary Artery Disease
Atrial Fibrillation
Hypertension
The Operating Model

One Service Line, Built on the Visits You Already Bill

Not a point solution bolted onto one condition — a named, governed service line with its own owner, P&L, and scorecard, following the Medicare patient from hospital discharge through long-term management across all five sites.

The Clinical Spine — TCM → RPM → PCM
  • TCM Structured 30-day post-discharge management — the billable bridge from Jackson-Madison County General and Dyersburg back into the practice for HF and post-procedure patients.
  • RPM Device-based physiologic monitoring (weight, BP, pulse ox) — the continuous early-warning and titration layer across HF, CAD, AFib, and hypertension panels, with GDMT titration run as a production process.
  • PCM Principal Care Management for the single high-risk cardiac condition — cardiology-native chronic management between the acute event and stability.
The Longitudinal Layer + Shared Engine
  • CCM Multi-condition chronic care management for the roughly 4-in-5 Medicare patients with two or more chronic conditions underneath every cardiac diagnosis — a natural fit for a practice that also runs primary-care and diabetes ancillary lines.
  • Engine Enrollment outreach, cellular devices, 24/7 alert triage, nurse navigation, billing capture, analytics — built once by CoachCare, reused by every program and every site.
  • Staffing Includes an on-site enrollment specialist staffed at CoachCare's expense — embedded value, not a practice cost.
The one coordination rule: RPM stacks with TCM, CCM, or PCM in the same month, but CCM and PCM serve different patients differently — CCM wraps the multi-condition panel, PCM concentrates on the single dominant cardiac diagnosis. One attribution policy, set at charter, keeps every patient in exactly one management lane with RPM layered on top.

The CY2026 Billing Stack

ServiceCodes~CY2026 MagnitudeCardiovascular Use
Transitional Care Management99495 · 99496~$200 / ~$280Every HF and post-procedure discharge
RPM setup & device supply99453 · 99454 · 99445 (new)~$20 setup · ~$52/mo99445 unlocks 2–15-day post-procedure windows
RPM treatment management99457 · 99458 · 99470 (new)~$52 + ~$41 add'lMonthly review, titration, escalation
Chronic Care Management99490 · 99439~$60 + ~$47 add'lMulti-condition panel — HTN, diabetes, CKD under the cardiac diagnosis
Principal Care Management99426 · 99427~$60 + ~$50 add'lSingle high-risk condition (HF) ≥3 months

Illustrative national non-facility magnitudes. The Value Analysis below uses MAC-locality rates auto-resolved for zip 38305 (carrier 10312, locality 35 — Tennessee). Verify against the current CY Physician Fee Schedule.

The Hub-and-Spoke Advantage

Your Patients Are Rural.
Their Monitoring Doesn't Have to Wait for Clinic Day.

McKenzie sees a cardiologist on Mondays. Ripley sees one a single day each month. Between those visits, a decompensating heart-failure patient in Carroll or Lauderdale County has two options today: drive to Jackson, or wait — and waiting is how emergency admissions happen.

Remote physiologic monitoring inverts that geography. Cellular devices report weight, blood pressure, and pulse ox daily from the patient's home — no portal setup, no Wi-Fi required — and a 24/7 monitoring team escalates by protocol to your clinicians. The practice's clinical reach becomes every day, in every county, while the visit schedule stays exactly as it is.

The coverage math: a satellite patient seen quarterly has ~4 clinical touchpoints a year. The same patient on RPM generates daily readings and a monthly managed touch — over 300 additional days of clinical visibility per year, each one billable under the CY2026 stack.

Five Sites, One Continuous Panel

Clinic-day coverage today vs. remote-care coverage with the service line
LocationCardiology On-SiteWith RPM
Jackson (hub)Monday–FridayDaily
LexingtonMonday–FridayDaily
DyersburgMonday–FridayDaily
McKenzieMondays onlyDaily
RipleyOne day per monthDaily

Site schedules from the practice's published locations (July 2026). RPM coverage is continuous wherever cellular service reaches the patient's home.

Recurring P&L — The Lead Lever
A standalone, margin-positive service line first. $1.95M modeled 24-month net reimbursement and $821K practice margin from TCM, RPM, CCM, and PCM — recurring professional-fee revenue on the panel you already manage, margin-positive from month two, before counting a single dollar of avoided cost.
Readmissions & Referral Defense
~52 modeled hospitalizations avoided ≈ $780K in acute-care cost at $15K per admission over 24 months. Post-discharge continuity protects the practice's standing with the hospitals and primary-care physicians who send it patients — in a market where a system-employed cardiology group competes for the same referrals.
Procedural Throughput
RPM-enabled recovery surveillance after WATCHMAN, interventional, and EP procedures — the new 2–15-day codes make the post-procedure window billable, support earlier discharge decisions with your hospital partners, and keep procedural capacity turning.
Renal-Denervation Whitespace
No practice in the Jackson market runs a renal-denervation program for resistant hypertension today. A disciplined hypertension RPM panel — daily BP data, documented medication response — is exactly the clinical substrate an RDN program is built on. Building the panel now creates the option, and the referral base, to claim that whitespace first.
Direct · Bi-Directional · Native

True Epic Integration, In the Chart You Already Use

Since October 2025 the practice has run on Epic through its hospital partner's instance, with MyChart live for patients. CoachCare integrates directly and bi-directionally with Epic — practices enroll and monitor remote-care patients inside built-in Epic workflows, without learning a new system. The whole program lives in the Epic environment.

Epic Hospital-partner instance · MyChart One chart & in-basket Orders & flags Flowsheets / vitals MyChart Billing workqueues CoachCare Remote care platform Cellular devices 24/7 monitoring Health coaches Enrollment team Billing engine FROM EPIC Enrollment flags & trigger orders Patient health history BACK INTO EPIC Discrete vitals — in the flowsheet, not PDFs Care summary & compliance documentation Real-time enrollment status Claims — auto-generated, every patient, every month Clinicians never leave Epic — the program lives in the chart they already use

< 5 days

from enrollment flag to a patient receiving billable RPM and care-management services.

The only one

CoachCare is the only care-management platform integrated with Epic that provides automated claims creation via its billing engine.

"Key to achieving a program that is efficient, effective and sustainable, is creating a seamless, intuitive user experience for the patient and provider, and that's what our integration with Epic accomplishes."

One discovery item: because the practice's Epic access runs through its hospital partner's instance, the specific integration pathway (direct connection vs. configuration through the hosting build) is confirmed during technical scoping. The vendor is not in question — the practice is on Epic today.

CoachCare Value Analysis · Modeled for the Heart & Vascular Center of West Tennessee

The Value Analysis

A 24-month forecast for the practice: an estimated ~2,250-patient Medicare panel (range 2,000–2,300 — validate in discovery), 14 referring providers (6 physicians + 8 APPs) plus a dedicated on-site enrollment specialist, Tennessee MAC-locality rates for zip 38305, Epic integration. Avoided-readmission savings and procedural-throughput gains are not in these numbers; they are upside on top.

Enrolled Patients Under Active Remote Care

Monthly active census by program · physician referrals (5/provider/mo, 70% acceptance) + 1 on-site enrollment specialist (80/mo), net of discharges

Monthly Economics — Revenue, Fees, Margin

Net reimbursement (after denials, coinsurance bad debt) vs. CoachCare fees; margin turns positive in month 2

24-Month Net Reimbursement Mix

$1.95M total across the three-program stack

The Financial Summary

ProgramYear 1Year 224-Month
RPM net reimbursement$273,851$434,643$708,494
CCM net reimbursement$281,749$492,116$773,865
PCM net reimbursement$115,161$350,588$465,749
Total net reimbursement$670,760$1,277,347$1,948,108
Practice margin (after fees)$273,199$547,644$820,843
Includes an on-site enrollment specialist staffed at CoachCare's expense — embedded value already reflected in the fees above.

Figures are illustrative and modeled — verify against practice data. Full model available as a companion workbook.

Scenario Explorer — Build Your Own Forecast

Adjust the assumptions and watch the 24-month forecast recompute live. Directional, calibrated to the CoachCare Value Analysis engine — the companion workbook remains the source of truth.
24-mo net reimbursement
$1.95M
24-mo practice margin
$0.82M
Enrollments at month 24
1,193
Hospitalizations avoided
~52
38,432

Billed Claims / Units

Recurring, subscription-like professional-fee volume over 24 months.

82,336

Physiologic Readings

A continuous clinical picture of the HF, CAD, AFib, and HTN panels between clinic days.

~52

Hospitalizations Avoided

≈ $780K in avoided acute cost at $15K per admission — felt directly by your hospital partners.

9.1

FTE-Years Absorbed

19,016 care-team hours of monitoring, outreach, and documentation handled by the service line.

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 the practice's physicians govern protocols and every clinical decision. Full-service delivery means launch requires no new headcount: your clinicians review escalations and sign orders; the service line does the rest.

Schedule the Working Session
0–30 Days

Charter the Service Line

Named owner, P&L, scorecard; Epic integration scoping and billing configuration; attribution policy for CCM vs. PCM lanes; protocol sign-off for HF, CAD, AFib, and HTN pathways.

31–90 Days

Pilot at the Jackson Hub

Two anchor cohorts: HF discharges from Jackson-Madison County General with TCM contact within 2 business days, and the hub's hypertension panel on daily BP monitoring.

91–180 Days

Extend to Lexington & Dyersburg

Full-week satellite sites join enrollment; post-procedure short-window RPM live for WATCHMAN, interventional, and EP recovery; monthly scorecard reporting to practice leadership.

181–365 Days

Close the Rural Loop

McKenzie and Ripley panels enrolled — daily monitoring where the cardiologist visits weekly or monthly; hypertension panel matured toward the renal-denervation opportunity; year-one economics reviewed against this analysis.

The Proving Ground

Pilot It Where Everything Converges: The Jackson Hub

Centre Plaza Drive is the natural pilot site — the practice's headquarters, its highest patient volume, its imaging and procedural coordination, and the shortest loop to Jackson-Madison County General discharges. The highest-acuity patients and the clinicians who follow them already sit in one building, on one Epic chart.

A Jackson-first launch concentrates enrollment where volume already flows, lets one site'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 five-site rollout a data decision, not a leap.

Scale path: Jackson proves it → Lexington and Dyersburg join in the second wave → McKenzie and Ripley complete the network. Same protocols, same Epic build, zero re-implementation — and the biggest clinical gains land at the sites with the fewest clinic days.

The 90-Day Jackson Pilot

Two anchor cohorts: HF discharges & the hub's hypertension panel
MilestoneTarget
Epic integration + protocol sign-offDay 30
First billable enrollmentsDay 30–45
48-hour TCM outreach rate≥ 90%
7-day post-discharge follow-up rate≥ 70%
Active program enrollments by Day 90*~195
Go / scale decision with full unit economicsDay 90

*The modeled months 1–3 practice-wide enrollment ramp (40 → 105 → 195 active program enrollments), concentrated at the hub during the Jackson-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
  • ~2,250 Medicare patients estimated for the practice, derived from reported Medicare allowed amounts (≈$2.94M ÷ ~$1,300 per beneficiary-year, a cardiology-calibrated divisor) = 2,261, modeled at 2,250 with a plausible range of 2,000–2,300. This is a modeling estimate, not a chart count — validate in discovery.
  • Full panel in scope from Year 1; eligibility 60% (RPM), 70% (CCM), 70% (PCM); enrollment conversion 30% (RPM), 25% (CCM/PCM) — yielding enrollment ceilings of 405 (RPM, reached ~month 10), 394 (CCM, ~month 11), and 394 (PCM, ~month 21).
  • Enrollment pathways: physician referral (5 referrals/provider/month across 14 providers at 70% acceptance) plus one on-site enrollment specialist at 80 enrollments/month, staffed at CoachCare's expense.
  • Active program enrollments (1,193 by month 24) count patients per program; a patient in two programs counts twice. Unique patients ≈ RPM census + 30% of other-program census under the model's 70% dual-enrollment assumption.
Rates & revenue mechanics
  • CY2026 Physician Fee Schedule rates auto-resolved by MAC carrier/locality for zip 38305 (carrier 10312, locality 35 — Tennessee); 2.5% denial rate; 20% coinsurance with 25% coinsurance bad debt; 1.5% monthly attrition.
  • CoachCare fees in this analysis reflect an 18% multi-program pricing accommodation off list rates, plus one-time implementation and EMR-integration fees that land in month 1.
  • Month-1 economics are net-negative (−$5,134) because those one-time fees precede the enrollment ramp; the program is margin-positive from month two (+$3,941) and every month thereafter.
  • Code-level capture assumptions (e.g., share of managed months billing 99457 and 99458) are itemized in the companion Value Analysis workbook.
Practice & market facts (verified July 2026)
  • Provider roster (6 physicians, 8 APPs), five locations and their schedules, and service capabilities are from the practice's public website, fetched July 2026.
  • Epic with MyChart live since October 3, 2025, via the practice's hospital partner's instance (practice website, patient-portals page). The integration pathway through that instance is a technical-scoping item; the vendor is confirmed.
  • Outsourced remote device monitoring for pacemakers/ICDs is listed on the practice's services page — cited here as evidence of a working partner model, not as a program CoachCare replaces.
  • The practice's affiliated hospitals (per its website) are Jackson-Madison County General Hospital and the Dyersburg hospital campus; readmission economics referenced here are the industry-standard HRRP mechanics that apply to those facilities.
  • As of the July 2026 public CMS selection lists, neither the practice's clinicians nor its affiliated hospitals appear in mandatory CMS payment-model cohorts for cardiology; this analysis therefore models fee-for-service economics only.
  • Renal denervation: no Jackson-market program was found in July 2026 research; the whitespace framing is an opportunity statement, not a claim about the practice's current capabilities.