Principal Care Management
Extra support between office visits for patients managing one complex or high-risk digestive condition.
A chronic gastrointestinal condition can feel like a full-time job. Keeping track of medications, appointments and changing symptoms is not easy — and a lot can happen between visits to your provider. Principal Care Management (PCM) is a Medicare-supported program designed to give you ongoing, between-visit support so you don't have to manage it all on your own.
What Is Principal Care Management?
Principal Care Management (PCM) is a service originally developed by Medicare for patients who have one complex or high-risk chronic condition. It’s designed to add a layer of clinical support between in-office visits with your gastroenterologist.
PCM is closely related to Chronic Care Management (CCM). The main difference is who each program is for:
- Principal Care Management (PCM) — for patients with a single complex or high-risk chronic condition.
- Chronic Care Management (CCM) — for patients with two or more chronic conditions.
GI of the Rockies has partnered with Cosán, a connected care management company, to deliver this program to our patients. Through this partnership, eligible patients are matched with a dedicated care coordinator who works with GI of the Rockies to support your care plan.
Who the Program Is For
Your GI of the Rockies provider may identify you as a candidate for PCM if you are living with a complex or high-risk digestive condition that benefits from ongoing monitoring and support, such as:
- Inflammatory Bowel Disease (IBD), including Crohn’s Disease and Ulcerative Colitis
- Chronic liver disease
- GERD and chronic acid reflux
- Celiac disease
- Pancreatic disease
- Other long-term gastrointestinal conditions
Eligibility is determined by your provider based on your individual diagnosis and care plan. If you have any questions about this new program offering, please reach out to your GI specialist. We’re here to answer your questions. So far, we’ve received excellent feedback from patients who are using this service.
What the Program Includes
A Personal Care Coordinator
You are matched with a dedicated care coordinator who works with you and your GI of the Rockies provider to follow your individualized care plan.
Symptom Check-ins
Your care coordinator checks in with you regularly by phone, text or email to track how you're feeling and reports any changes back to your provider
Medication & Appointment Help
The care coordinator can help with refill requests, scheduling appointments and reminders so things don't fall through the cracks between visits.
Health Education & Local Resources
You can ask questions about your condition and get connected to community resources, such as transportation services, support groups and nutrition help.
A Familiar Voice
Most patients work with the same care coordinator over time, so you have a consistent point of contact who is familiar with you and your health history.How the Program Works
Your GI provider identifies you as a candidate.
During a visit, your GI of the Rockies provider may suggest PCM if it fits your condition and care plan.
You give consent to enroll.
Medicare requires your verbal consent before PCM services start. You will be told what services are included and what cost-sharing, if any, may apply. You may also receive a recorded call or email from Cosán on behalf of your provider to help start the enrollment process.
You are matched with a Care Coordinator.
Your Care Coordinator reviews your care plan with the GI of the Rockies team and reaches out to introduce themselves.
Ongoing support between visits.
You receive regular check-ins, help with medications and appointments and a single point of contact for questions about your condition.
Insurance & Cost
Principal Care Management is covered under Medicare Part B. You don’t need to be a Medicare beneficiary to participate — most commercial plans and Medicare Advantage plans also cover this benefit.
Like other healthcare services, PCM is subject to your annual insurance deductible, coinsurance and copay:
- If you have a secondary or supplemental insurance, your copay may be covered in full. This depends on your specific plan.
- If you do not have secondary insurance, or have not met your deductible, you may have a small monthly out-of-pocket cost. (For most patients with traditional Medicare, this is typically no more than around $10 per month, but actual amounts depend on your plan.)
- A small program fee may apply depending on your specific benefits.
We recommend confirming your specific cost-sharing with your insurance carrier before enrolling.
Is My Health Information Private?
Yes. The Cosán care management platform is built on the same standards as electronic medical record (EMR) systems and is designed to meet HIPAA and HITECH requirements. Your health information is shared only with your GI of the Rockies care team and the Cosán care team supporting your plan.
FAQS
Principal Care Management (PCM) is a Medicare-supported service that adds a layer of clinical support between provider visits for patients living with one complex or high-risk chronic condition.
Ready to Get Started?
If you think Principal Care Management may be helpful for managing your condition between visits, the next step is simple:
- Bring it up at your next GI of the Rockies appointment, or
- Call our office at 303-604-5000 to ask whether PCM is available for your condition.
Your provider will let you know if you’re a candidate and walk you through what to expect.
Principal Care Management is an informational support service offered through a partnership between Gastroenterology of the Rockies and Cosán. PCM is not a substitute for emergency care. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room. The information on this page is for general educational purposes and does not replace medical advice from your provider. Insurance coverage and out-of-pocket costs vary by plan; please confirm coverage details with your insurance carrie