HealthCheck+ at MFM Health
Ongoing Support for Managing Chronic Conditions
Your health doesn’t stop between visits—and neither do we. HealthCheck+ is MFM Health’s proactive care program designed for patients living with chronic conditions, including but not limited to, diabetes, hypertension, heart disease, and COPD. This program may include one or more of the following services, depending on your needs:
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Advanced Primary Care Management (APCM)
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Chronic Care Management (CCM)
These services work together to support your care plan, reduce health risks, and improve your day-to-day well-being.
Program Overview
HealthCheck+ offers regular, personalized support outside of your standard office visits. We work closely with you through phone calls, virtual check-ins, and in some cases, at-home devices that monitor your health in real time (Remote Patient Monitoring/RPM). All services are coordinated by your care team to ensure you get the right level of care at the right time.
What is Advanced Primary Care Management (APCM)?
APCM is designed for patients with two or more chronic conditions with support established such as:
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A personalized care plan
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Coordination between health care settings and with specialists
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Education and monitoring of chronic conditions and medication adherence
APCM focuses on preventing complications and helping you stay on top of your health goals.
What is Chronic Care Management (CCM)?
CCM provides additional support between office visits for patients managing ongoing conditions. Services include:
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Personalized Care Plan
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Improved access to care through available telehealth appointments, extended office hours, access to 24/7 triage nurse support.
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Telephone outreach from our care management team for symptom monitoring and management of chronic conditions.
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Assistance with coordination of care across the healthcare system including discharge from inpatient settings to outpatient referrals.
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Education on symptom and disease management to help with better medication adherence, lifestyle changes and self-management strategies to improve overall health.
What is Remote Patient Monitoring (RPM)?
RPM uses connected health devices to send vital health data directly to your care team. This might include:
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Blood pressure monitors
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Glucose monitors
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Weight scales
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Pulse oximeters
The data from these devices is reviewed in real time by our pharmacist partners at V-Care Pharmacy and outreach to your provider is made if anything concerning is detected.
RPM helps us catch potential issues early and fine-tune your treatment as needed, often times without requiring a visit to the office.
Note: RPM may be recommended based on your health needs. Costs and coverage vary by insurance. Our team will walk you through your benefits before you begin.
Continuous Support
Stay connected with a dedicated care coordinator who tracks your health progress between visits.
Comprehensive Care
Your care is seamlessly coordinated between your primary care provider and specialists.
Improved Outcomes
Proactive monitoring detects changes early, preventing emergencies.
Convenience
Access care remotely without leaving home—our team is just a call away.
Benefits of HealthCheck+ at MFM Health
How do I know if I’m eligible?
Patients with two or more chronic conditions expected to last 12 months or more are typically eligible for HealthCheck+. These may include conditions such as diabetes, high blood pressure, heart disease, asthma, or depression.
You may receive proactive outreach from MFM Health inviting you to enroll, or your provider may discuss the program with you at your next appointment. If you’re not sure whether you qualify, your care team can review your medical history and let you know if HealthCheck+ is a good fit for you.