Empower your patients through Chronic Care Management. Click Here
Talk with A ChartSpan Representative
Talk with a ChartSpan Representative Today!

Our team is ready to help you improve patient care and outcomes.

Contact Us


9 Ways to Increase Patient Retention with Chronic Care Management

Jon-Michial Carter
Written by Jon-Michial Carter

Patient retention is a cornerstone of effective, patient-centered care. It influences patient satisfaction, communication, compliance with treatment plans, and medication adherence. Patient loyalty results from strong patient-provider relationships and is developed through trust, consistency, and high-quality care

Loyal, returning patients are cost-effective, generate recurring revenue*, and can help expand your practice’s patient base through their recommendations. Furthermore, patient retention is correlated with better clinical outcomes for individual patients.

Patients with multiple chronic conditions are at greater risk of experiencing poorly coordinated care and experiencing gaps in their care journey. This can lead to dissatisfied and disengaged patients, who ultimately abandon their providers in search of more attentive, personalized care.

Chronic Care Management (CCM) programs enable healthcare providers to deliver high-quality, personalized care to eligible Medicare patients with at least two chronic conditions. The CCM model of care management emphasizes proactive and preventative treatment, facilitating lower healthcare costs and better clinical outcomes for patients. These positive metrics improve patient satisfaction and encourage patient retention. 

In this article, we will explore how CCM programs like ChartSpan help overcome barriers to care, encourage patient retention, and facilitate positive clinical outcomes for your patients.

*Results may vary by provider.  

What is patient retention?

Patient retention occurs when patients return to the same provider multiple times for care throughout their healthcare journey. At its essence, patient retention is a healthcare practice’s ability to convert a new patient into a loyal patient. 

Patient retention is one of the foremost indicators of overall patient engagement and satisfaction with a healthcare provider. Effective patient retention strategies result in uninterrupted, meaningful relationships between providers and their patients, improved long-term clinical outcomes, and higher quality of care. 

Patients who are engaged with their care trust their provider, and they are empowered to take preventative measures often return to a single practitioner throughout their healthcare journey.  When a single provider functions as a nexus of care for a patient, it improves the potential for that patient’s clinical outcomes while ensuring the practice has a recurring source of revenue. 

Why does patient retention matter?

Acquiring new patients costs a practice five times more than retaining their pre-existing patients. Healthcare practices that invest in marketing strategies prioritizing patient activation, engagement, and satisfaction are far likelier to reap financial rewards while strengthening patient trust. 

New patient acquisition is necessary for any practice or clinic's expansion and continued longevity. However, patient retention turns the valuable time your practice invests in your patients into a reliable, recurring revenue stream.

Patient retention also provides a wide array of health benefits to patients. Patients who remain with a provider they trust are more likely to comply with any proposed treatment plans, medications, and preventative screenings. This helps reduce gaps in care, which can be further exacerbated if a patient frequently switches between healthcare providers. Continuity of care and care coordination are also significantly easier for your practice to manage if a patient has a longstanding relationship with you.        

Practices with strong patient retention also naturally facilitate new patient acquisition. Loyal patients are more likely to assist your practice in patient acquisition through word-of-mouth referrals within your community. If patients experience exceptional care, they are more likely to recommend your practice to family, friends, and colleagues. 

Enthusiastic patients are also more likely to leave positive reviews for your practice online, providing you with invaluable social proof. Ensuring that the stream of online information about your practice is positive is crucial to attracting new patients that your practice can convert to lifelong, loyal patients.  

9 ways to increase patient retention with CCM

1. Empower patients through engagement and activation

One of the most substantial ways to solidify patient retention is through engagement. A CCM program's highly personalized and consistent services can help you activate and retain patients in your care. 

When patients believe their actions contribute to decreased discomfort and stress, improved clinical outcomes, and a more enjoyable quality of life, they are more likely to take a proactive role in their care journey. This has been documented across a wide range of chronic conditions, including diabetes, coronary disease, and rheumatoid arthritis. Research demonstrates that activated patients who enthusiastically and pre-emptively engage with the healthcare system also often incur lower healthcare costs and experience superior quality of care. 

Chronic Care Management services are well-equipped to activate patients on their care journeys. Through consistent communication with a care manager, patients experience engagement and education about their chronic illnesses, allowing them to become partners in their healthcare journey. 

Additionally, patients with individualized care plans created through Annual Wellness Visits (AWVs) or CCM are given insight into their health and explicit, actionable strategies to improve their health and proactively minimize the risk of new or worsening conditions.  As patients’ confidence in their ability to navigate the healthcare system increases, they become stronger self-advocates and more likely to seek out preventative care proactively. The more engaged they are with their care, the likelier your practice is to retain the patient. 

Learn more: The profound impact of CCM on patient outcomes.

2. Increase annual touchpoints through monthly communication

Extending care beyond the walls of your practice is a powerful way to stay connected to patients and subsequently strengthen patient loyalty. Suppose the extent of a patient’s interaction with your practice (and perhaps, the healthcare system overall) is relegated to a handful of appointments a year. In that case, they may be more swayed to seek out your competitors. 

However, when they engage with your practice every month, this adds a minimum of twelve additional touchpoints every calendar year. CCM services require care managers to devote at least 20 minutes of clinical staff time each month to every enrolled patient. 

During these calls, care managers field questions about new and worsening symptoms, arrange for medication delivery and appointment transportation, and provide resources that assist patients in self-management. The cumulative effect builds patient loyalty and trust over time, significantly contributing to patient retention. 

Providing patients with consistent, reliable access to knowledge bases and resources promotes accountability and helps encourage patient retention. Patients are less inclined to seek alternative practices or physicians when they feel they receive high-quality and attentive care. The high-touchpoint communication style of CCM facilitates positive communication, answers patient questions, and provides timely clinical interventions. 

3. Help patients access medication, transportation, and community resources 

CCM care managers are primed to identify and address obstacles patients encounter while accessing care through their regular communication cadence. Left unaddressed, these obstacles can lead to patients missing potentially life-saving screenings, discontinuing essential medications, or skipping medical procedures to redirect their limited income toward food or shelter. This can result in the worsening of treatable and preventable conditions, the acceleration of chronic illnesses, and a deteriorated quality of life for patients.

For example, if patients cannot access reliable transportation, they are more likely to miss appointments. If this appointment is for a screening for a patient unaware they are currently in the early stages of breast cancer, the missed appointment can have detrimental consequences. The cancer may not be discovered until months or years later, and the treatment options are likely to be more complex, invasive, and expensive. 

However, if they relay to their care manager that they cannot drive themselves to the appointment, the care manager can arrange transportation for the patient. This is one of the many crucial ways CCM closes gaps in care. 

Care managers can connect patients to resources designed to address Social Determinants of Health (SDOHs). They can arrange for medication delivery, connect food-insecure patients to community resources like food pantries, and help isolated patients find social gatherings through local senior centers.

If patients know they can rely on their CCM care manager to assist them with scheduling, medication delivery, and transportation, they will likely feel greater satisfaction and receive a higher quality of care. Patients who receive this holistic care are encouraged to stay with a practice to reap the benefits of the hands-on, personalized engagement offered by CCM services. 

Learn more: How to reduce medication non-adherence through CCM

4. Educate patients about their conditions

When patients understand the complexity of their chronic conditions and are given achievable and productive means of self-management, they are more likely to stay engaged in their care journey. Providing patients with ongoing education about their conditions, medications, and lifestyle risk factors is a powerful way to foster this engagement. 

If patients only see their primary care provider once or twice a year, they have limited opportunities to ask them questions. When a patient is contacted monthly by a care manager, this offers them at least twelve additional opportunities to expand their health literacy throughout the year. 

For example, if a patient is experiencing an unwanted side effect from a new medication, they may discontinue it without seeking professional advice. However, if their care manager calls and asks them about this medication that month, a conversation can be started about its importance. The care manager can offer solutions to help mitigate the side effects or schedule appointments with the appropriate healthcare providers for alternative treatment options. In fact, a care manager at ChartSpan had this exact scenario occur and was able to help the patient meet with their provider to discuss their medication’s side effects. 

The gap in care is pre-emptively closed, the patient’s trust in their wellness plan is increased, and any consequences from a yearlong abstinence from the medication are avoided. Patient education is a valuable tool in encouraging better clinical outcomes, lowering healthcare costs, and elevating patient satisfaction, which directly influences patient retention. 

5. Offer 24/7/365 access to a nurse care line 

Access to accurate and reliable healthcare information is notoriously challenging with the surplus of information on the Internet. However, CCM companies, like ChartSpan, offer enrolled participants 24/7 access to a nurse care line every day of the year.

Enrolled patients can access these nurses' compassionate advice and clinical expertise regardless of the time or the day of the week. Patients can use the care line to discuss symptoms that may be alarming them. The nurses can quell patients' fears or escalate the call to emergency services if they identify the patient is at serious risk. 

Patients can also use the care line to ask questions about lifestyle factors, express mental health concerns, double-check medication information, and request self-management guidance. Best of all, your patients can rest assured the advice they are receiving is vetted by medical professionals and specific to their conditions and medical backgrounds. 

This uninterrupted access to medical advice and insight is a phenomenal way to incentivize patient retention. Patients will no longer have to rely on online information, which can often be alarmist and inaccurate. Additionally, the 24/7/365 availability of the nurse care line ensures that no patient is ever alone in their care journey. No matter the size or severity of their problem, they have immediate access to a medical professional ready to guide them. 

6. Reduce hospital admissions and readmissions

Effectively administered CCM results in reduced hospital admissions for patients. CCM’s strong emphasis on proactive and preventative care encourages patients to address health risks early on. This often results in patients managing conditions before they escalate to emergencies. 

Additionally, patients enrolled in CCM programs can lean on the expertise of their care managers and the nurse hotline to ask questions about medications, new and worsening symptoms, or other healthcare concerns they’re experiencing. The CCM team collects this information and can help guide patients toward appropriate and timely interventions if they notice troubling developments. 

Case studies have found that Chronic Care Management services can reduce hospital readmissions by 6.2%. In 2023, ChartSpan CCM customers saw readmissions fall by 22-52%. Additionally, studies have demonstrated that patients with solid health literacy who are educated about their medications, conditions, and risk factors are 30% less likely to be readmitted to the hospital. The regular communication cadence provided by a CCM program ensures that patients have ample opportunities to learn about their chronic illnesses and strengthen their self-management skills, helping them avoid hospital readmission. 

When a patient’s hospitalizations are reduced, this bolsters their trust in their provider and wellness plans. This encourages patient retention and reinforces a patient’s confidence in the quality of their care.  

7. Lower healthcare costs for patients 

Patients enrolled in CCM see an average of $240 in savings on annual out-of-pocket healthcare expenditures.*  In 2023, patients enrolled in ChartSpan CCM saw average annual savings of $2,457 per patient. These cost savings are achieved through reduced hospitalizations, readmissions, outpatient services, and skilled nursing facility admissions. 

Chronic Care Management services strategically target an acute population at risk of becoming high utilizers of the healthcare system. Most patients living with multiple chronic conditions run the risk of excessive or avoidable medical interventions between provider visits when their conditions are not adequately managed. These risk factors can be mitigated through deliberate wellness planning and an ongoing communication cycle, ultimately saving patients money. 

When patients understand that they can save money and see better clinical outcomes by enrolling in CCM services, they are more inclined to stay with the program. Furthermore, your practice is more likely to retain a patient who recognizes that they are receiving both physical and financial benefits through your CCM program. This gives you a distinct advantage over other practices, which may not offer CCM or struggle with a poorly implemented in-house program.

*Results may vary by provider. 

8. Coordinate seamless care across providers and practices

When patients receive treatment for multiple chronic conditions, they likely see numerous healthcare specialists across various healthcare organizations and networks. If information is not shared across these channels, it creates gaps in care coordination. This can lead to patients paying for redundant tests, overuse of medications, and avoidable admissions to hospitals and care facilities. Gaps in care contribute to patient confusion, frustration, and disengagement with the healthcare system and your practice. 

CCM care managers can spot redundancies and complications that arise when a patient receives care from multiple channels. Through monthly conversations, care managers can track whether patients receive screenings or specialty treatment through medical organizations separate from your practice. Care managers can request medical records for the enrolled CCM patient and add the information to the patient’s record. This eliminates the risk of gaps in care coordination and creates a smoother flow of information for practices and patients alike. 

When patients feel that capable, caring professionals are coordinating their care, it instills confidence in both the quality of their care and the competency of their care providers. A CCM program can help your practice tackle the daunting task of care coordination, bolstering patient trust and satisfaction and encouraging higher patient retention. 

9. Provide patients with emotional support 

Anxiety, depression, stress, and loneliness are all biophysical stressors that can have a detrimental impact on a patient’s physical health. When patients battle multiple chronic conditions, they are susceptible to becoming overwhelmed by these mental health struggles, especially if they do not have a channel where they can vent their frustrations and fears. This is especially true for elderly patients, who may have smaller social circles and fewer opportunities to seek emotional relief.

However, a monthly call with a CCM care manager can enormously impact a patient’s morale. The call gives patients a regular opportunity to share their conditions and any obstacles or challenges they face with a human being. These conversations can make substantial differences for patients without an outlet for these frustrations.

Furthermore, care managers can administer PHQ-2s (clinical depression screenings). If they find the patient could benefit from mental and behavioral health treatment, this information can be passed on to the primary care provider. When patients feel your practice’s CCM service meets their emotional needs, you are more likely to retain them as loyal, satisfied, engaged patients throughout their care. 

Increase patient retention through ChartSpan’s turnkey CCM program 

Loyal, satisfied, and healthy patients are fundamental to the ongoing success of your practice. At ChartSpan, we understand how to strengthen and maintain your patient relationships. Our industry-leading, turnkey CCM services have proven effective for many healthcare providers, and we’re eager to share our expertise and deep knowledge base with your team.

Through consistent and compassionate communication, our team of care managers will educate, activate, and engage your patients. As we guide patients on their care journey between clinical visits, we will ensure that their care is efficiently coordinated, gaps in care are identified and addressed, and obstacles like transportation access are overcome. 

In addition to building relationships with your patients, we will help them manage the physical, emotional, and mental challenges of chronic conditions. When the quality of their care improves and their out-of-pocket costs lower, patients should see better clinical outcomes and feel a robust sense of trust and confidence in the care you and your team provide. 

With ChartSpan, your practice can elevate its quality of care and encourage greater patient retention. Contact us today to learn more about Chronic Care Management's transformative benefits. 

You may also like: 

Empower your providers and delight your patients!

Proactively address patient health with preventive care programs that provide more revenue for your practice and more personalized care for your patients.

Talk to an Expert