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chronic care management

Chronic diseases are a leading cause of death and disability in the US. Current models for Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) often suffer from low usage and limited accessibility, especially when controlled solely by Primary Care Physicians. 


Aspire Integrated Healthcare Solutions is launching an innovative model to expand and optimize these services by taking them directly to consumers and other organizations for large-scale enrollment. This approach has the potential to significantly enhance healthcare outcomes, reduce hospital remissions, improve patient well-being, and reduce healthcare expenditures. Furthermore, leveraging new innovative technology by Aspire and our partners such as telehealth, AI chatbot, Aspire Health Toolkit, AI-powered analytics, and more, can address barriers like member enrollment, member engagement and interest in the program, stigma, and lack of awareness of resources.

Read more about the Medicare Chronic Care Management program.

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program summary

The Aspire CCM Program

 Our innovative model is different from the standard Medicare CCM model that is failing with low usage and controlled by Primary Care Physicians. We plan to take this model direct to consumers and other organizations for a large scale enrollment and implementation of this proven CCM program.

Get Started

Aspire Technologies

 1. Easy Member Enrollment process: we offer the members, their families and care teams an easy enrollment process into the Aspire CCM program. 

2. Aspire Health Portal and Mobile App has enhanced functionalities for CCM care navigation, personalized dashboards, secure messaging, and resource access.

3. The Aspire Health Assistant (AHA) is our AI agent that offers interactive conversations and real-time support.

Toolkit

Chronic Care Management Services "CCM"

Aspire partners with the best CCM management companies that provides comprehensive, coordinated healthcare services for patients with multiple chronic conditions. Key features include:

● 24/7 Access to Care Coordination – Ensuring seamless communication between patients, providers, and caregivers.

● Personalized Care Plans – Developing individualized treatment strategies based on patient needs.

● Medication Management – Supporting adherence and reducing adverse drug interactions.

● Behavioral & Mental Health Support – Integrating psychological well-being into chronic disease management.

● Data-Driven Insights – Utilizing electronic health records (EHR) to track patient progress.

Remote Patient Monitoring "RPM"

RPM services allow real-time tracking of patient health metrics through FDA-approved medical devices and AI-powered analytics. Key benefits include:

● Real-Time Health Monitoring – Continuous tracking of vital signs such as blood pressure, glucose levels, heart rate, and oxygen saturation.

● Early Intervention & Risk Reduction – Detecting health deterioration before it leads to hospitalization.

● Enhanced Provider-Patient Engagement – Enabling timely interventions through telehealth and digital reporting.

● Integration with CCM Services – Providing a holistic approach to chronic disease management.

Psychosocial Remote Monitoring

Our Measurement-Based Care platform is an evidence-based psychosocial assessment tool that involves tracking client progress throughout treatment, using consistent Patient-Reported Outcome Measures (PROMS). It provides an avenue for clinicians and their clients to regularly check in with each other, reflect on objective symptom change data together and uncover insights or patterns that can inform treatment decisions. The system sends alerts to the care teams anytime the client is experiencing any emotional distress so they can promptly intervene.

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Downloads

Brochure_Chronic Care Management_Medicare (pdf)Download

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