Research & Education

How to Scale CCM Across Locations Without Chaos

Tara Trimarchi and Jon-Michial Carter bring a client's and a care management partner's perspective as they share practical insights into launching care management across a major health system.

Recorded July 2026Topics: Chronic Care Management, Webinar, On-Demand, Enterprise health systems, Patient enrollment

Watch the Recording

Key Takeaways

Main Line Health approached seven figures in net profit within its first year of partnering with ChartSpan.
Managing 50,000+ outbound and 11,000+ inbound patient calls monthly requires dedicated enrollment and clinical systems that most health systems cannot build in-house.
When it comes to patient enrollment, personalization is key. Ringless voicemails from individual providers drove enrollment increases.
8,000 care gaps were addressed in one year.
Main Line rolled out their program in stages, starting with select practices before scaling to other practices over the course of several months.

About the Speakers

Tara Trimarchi

System Director, Care Coordination Services
Main Line Health

As System Director of Care Coordination Services, Tara Trimarchi oversees rising- and high-risk care management programs across Main Line Health's 42 primary care-practice, 300-provider network. She leads the operational and clinical infrastructure behind Main Line's care coordination programs, including their partnership with ChartSpan.

Jon-Michial Carter

Founder and Chief Growth Officer
ChartSpan

Jon-Michial Carter is the founder of ChartSpan, which has grown into the nation's largest Chronic Care Management provider. He focuses on building scalable care management programs across the U.S. and recently led the launch of ChartSpan's Advanced Primary Care Management program.

About Main Line Health

At a Glance

Type

Health System

EHR

Epic

Locations

42 primary care sites across greater Philadelphia

Value-based care

ACO

CCM-eligible population

33,000 beneficiaries

Program type

Chronic Care Management

Why Main Line Health Chose to Partner Instead of Build

For large health systems considering Chronic Care Management, the first decision is whether to partner with a vendor or build a program in-house. Main Line Health had already built a robust care management program for its highest-risk patients.

But rising-risk patients, those with multiple chronic conditions who hadn't yet crossed into high utilization, were largely unsupported. Reaching out to these patients with Chronic Care Management became a strategic priority for Main Line.

They chose to partner with ChartSpan because of the infrastructure required to launch a program at scale, including enrollment management, compliance parsing, billing automation, 24/7 clinical staffing, and patient churn management.

"In terms of determining if we did it ourselves or partnered with ChartSpan, it was the operational infrastructure build that we were not willing or able to take on."

Tara Trimarchi
System Director of Care Coordination Services, Main Line Health

The operational infrastructure practices need to build is more complex than it appears from the outside. Eligibility parsing requires a continuously updated compliance engine: one that accounts for payer-specific reimbursement rules, exclusion criteria, capitation arrangements, and coordination with existing internal programs to avoid dual enrollment.

Main Line also recognized that building these systems would require pulling IT and revenue cycle staff away from existing priorities, and that sustaining the systems over time would likely require new staff. Partnering with ChartSpan offered access to a functioning operational infrastructure, without upfront investment or the requirement to hire new employees.

Main Line kept its high-complexity and transitional care management programs in-house. ChartSpan was engaged specifically for the longitudinal, rising-risk population, allowing both programs to operate without conflict.

The Enrollment Challenge: Building Patient Trust

For Main Line Health, enrollment was one of the most challenging but most educational areas of its ChartSpan partnership.

CCM carries a monthly co-pay for many eligible patients, which must be disclosed during every enrollment conversation. Jon-Michial Carter described the co-pay as the number one reason patients decline enrollment and the number one reason patients leave the program.

"You have to get ahead of it and be very clear in the enrollment script that a co-pay may be required, and be very clear about the estimate for what that co-pay is. We have found that the ChartSpan enrollment personnel are respectful if a patient is unwilling to pay the co-pay."

Tara Trimarchi
System Director of Care Coordination Services, Main Line Health

ChartSpan's enrollment specialists are trained to always discuss copays during enrollment. Main Line and ChartSpan also collaborated on custom enrollment scripting to address co-pays. However, they faced a second challenge: building trust that ChartSpan worked with Main Line.

They tackled this by cobranding many patient-facing materials to emphasize that care management came from Main Line Health as well as ChartSpan. Main Line's providers also jumped in to help. Individual providers recorded ringless voicemails for patients that ChartSpan could distribute, and enrollment rates climbed.

What No One Tells You About Implementation: EHRs, Provider Buy-In, and Onboarding

Once the decision to launch a CCM program is made, most enterprise health systems underestimate what comes next. For Main Line Health, the onboarding process with ChartSpan took approximately 12 weeks of build work, after roughly six months of exploratory sales conversations.

The Epic integration required effort from ChartSpan and Main Line to establish a bidirectional clinical data feed for care team messaging and to automate billing claim generation. Executive sponsorship up to the COO level was necessary to make the work a priority.

Main Line's staged rollout of starting with one or two practices, learning, adjusting, and scaling proved to be the right call for an enterprise system. If you are a large health system, identify a small number of practices with willing leadership and expect to make meaningful changes before expanding a care management program.

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Watch the Recording

The full conversation, on demand

Use the chapters below to jump to specific topics, or watch the full recording.

Chapters

0:00Introduction & Main Line Health at a Glance
4:05Why the Rising-Risk Population Was Being Left Behind
6:32Early Results: Enrollment Numbers, Inbound Calls & Revenue
11:01The Enrollment Process
15:21Co-pays: Addressing Friction & Patient Sentiment
34:42Onboarding Deep Dive: Epic Integration & Staged Rollout
38:34How Local Engagement, Co-Branding & Provider Support Improve Enrollment
43:26Lessons Learned & Closing Advice for Enterprise Health Systems

Full Transcript

Lightly edited for readability. Not intended as a verbatim record.

Webinar Transcript: Implementing an Enterprise Care Management Program

Featuring Tara Trimarchi, System Director of Care Coordination Services, Main Line Health, and Jon-Michial Carter, Founder and Chief Growth Officer, ChartSpan

Jon-Michial Carter: Hello everybody. Welcome to today's webinar: Practical Lessons and Insights. We have the good fortune of talking to a large health system that has recently integrated a care management program within their health system.

Tara Trimarchi: Thank you very much for inviting me to participate. I'm looking forward to this opportunity.

Jon-Michial Carter: What I'd like to do first, Tara, is have you give us a sense about Main Line. How large are they? How many providers? How many locations?

Tara Trimarchi: In terms of our primary care network, which is where we have implemented ChartSpan, we're upwards of 42 practices, about 300 providers. We engaged in a partnership with ChartSpan because we realized that we were missing the rising risk population.

Frequently Asked Questions

Common questions raised during the live session and afterward.

How often are patients called in a Chronic Care Management program, and do you have to have direct contact to bill for CCM?

ChartSpan attempts to reach every enrolled patient every month, but direct contact is not a CMS compliance requirement for billing. Only the attempt is required. ChartSpan's standard is that patients who haven't engaged with care managers in six months are automatically unenrolled.

Do the physicians approve a list of patients, or is it individually signed orders?

Main Line distributes a monthly list of ChartSpan-identified eligible patients to individual providers, who review and remove anyone they deem inappropriate for enrollment as part of general supervision. This list-based workflow also cross-references patients already enrolled in Main Line's internal ambulatory care management program to prevent dual enrollment.

Has Chronic Care Management been able to demonstrate improvements in quality metrics?

8,000 care gaps have been addressed. Since Main Line is still approaching its first full year of care management operation, the quality data gathering and outcomes analysis were just beginning. But process measures were proceeding as planned.

What types of issues did patients complain about in a CCM program?

The most common complaints focused on the co-pay and on enrollment outreach that felt too persistent. Some patients were skeptical of unsolicited calls and had difficulty distinguishing the program from spam. Strong alignment between ChartSpan and Main Line on enrollment materials and scripting helped address these concerns.

Does ChartSpan offer services in languages other than English?

Yes. To run a compliant CCM program, the service must be delivered in the patient's preferred language. ChartSpan maintains Spanish-speaking clinicians and enrollment specialists and uses translation services for additional languages.

What Enterprise CCM Implementation Actually Looks Like: Lessons from Main Line Health's First Year

ChartSpan and Main Line Health offer an honest account of what infrastructure, enrollment, and operational challenges look like at scale for an enterprise health system. If you'd like to see what a personalized program would look like for your practices, schedule a consultation with one of ChartSpan's CCM leaders.

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