The Nephrology Group built its own hypertension RPM, its own app, its own analytics — and turned CKCC losses into $1.86M of shared savings. The next chapter shouldn't run on a two-person dev team. Full-service, turnkey, and natively integrated with Greenway.
Month-24 census is ~2,809 active program enrollments (RPM ~2,069 + PCM ~740); the headline patient figure is 2,291 unique patients after de-duplicating those enrolled in both programs. All figures illustrative, modeled — verify against practice data.
Most practices need convincing that remote care works. TNG doesn't — it built the evidence itself. That conviction is the asset. The question is whether the next thousand patients should run on self-maintained infrastructure.
A dedicated hypertension center with self-run blood-pressure remote monitoring — clinical buy-in for RPM is already institutional.
A self-published patient app (App Store & Google Play, 2025) tracking BP, weight, and glucose — maintained by an in-house team of one manager, one engineer, and two interns.
NPs and PAs running care management manually — clinically excellent, operationally expensive, and the first place scale breaks.
PY2023: −$2.2M, 50% quality. PY2024: +$1.86M shared savings, 75% quality — as anchor practice of DaVita's Integrated Kidney Care of Central California.
CKCC has been extended through December 2027 — with tightened savings methodology from PY2026. The savings get harder to earn at exactly the moment operational leverage matters most.
None of these are criticisms — they're the structural costs of running a monitoring company inside a medical practice. Every practice that builds in-house meets the same six walls, usually between patient 200 and patient 1,000.
Shipping, provisioning, replacements, returns — an app-based model also excludes every patient who can't or won't use a smartphone, in a Medicare/Medi-Cal-heavy market.
Readings don't keep office hours. Alert triage at 2am either goes unstaffed or burns out the day team.
16-day supply counts, time-based documentation, code-stacking rules that changed again in CY2026 — audit exposure grows with every enrolled patient.
OS updates, store review cycles, HIPAA-grade security patches — carried by a two-developer team whose time the practice funds.
Home-grown data lives outside Greenway unless someone builds and maintains the pipes — so vitals end up in a portal nobody charts in.
In a self-built model every added patient adds staff load. In a full-service model every added patient adds margin.
TNG keeps its clinical protocols, its physician governance, its VBC team, and its patient relationships. CoachCare replaces the infrastructure underneath — as a service, not a project.
| Capability | TNG's Self-Built Program Today | CoachCare Full-Service |
|---|---|---|
| Clinical protocols & governance | Yours — proven by the AHA certification & KCE results | Stays yours. Physicians govern every decision. |
| Devices | App-dependent (smartphone required) | Cellular-connected devices — no app, no Wi-Fi, no smartphone needed; logistics handled end-to-end |
| Monitoring | Business hours, VBC team capacity | 24/7 clinical monitoring & alert triage, escalation to your protocols |
| Enrollment | Manual, clinic-by-clinic | Dedicated enrollment engine — two on-site enrollment specialists (at CoachCare's expense) + telephonic outreach across all 9 offices |
| Billing & compliance | Self-managed rules & documentation | Billing-grade documentation for every claim: day counts, time logs, audit trail |
| EHR integration | Data outside the chart | Native Greenway integration — vitals, alerts, and encounters flow into the record your clinicians already use. $2,500 one-time; $0 monthly; $0 per-patient* |
| App & platform maintenance | 2-person dev team | CoachCare's platform team — your developers return to analytics & KCE reporting |
| Unit economics | Each patient adds staff load | Each patient adds margin — modeled below |
*Greenway integration pricing per the CoachCare integration catalog — confirm in contracting.
A 24-month forecast using TNG's footprint — ~40 referring providers across 9 Central Valley offices, two on-site enrollment specialists, MAC-locality rates for zip 93720 (Noridian JE), and Greenway integration — for RPM + PCM across CKD 3b–5, hypertension, and transition-of-care populations. Conservative enrollment mechanics; CKCC shared-savings amplification not included in these numbers.
| Program | Year 1 | Year 2 | 24-Month |
|---|---|---|---|
| RPM net reimbursement | $657,044 | $2,005,950 | $2,662,994 |
| PCM net reimbursement | $209,529 | $655,761 | $865,291 |
| Total net reimbursement | $866,573 | $2,661,711 | $3,528,285 |
| CoachCare program fees | $482,168 | $1,507,725 | $1,989,893 |
| Ancillary & one-time fees | $20,253 | $17,620 | $37,873 |
| Practice margin (after all fees) | $364,153 | $1,136,366 | $1,500,518 |
| Includes two on-site enrollment specialists staffed at CoachCare's expense — ≈$240,000 of embedded staffing value over 24 months. That value is CoachCare's expense and is never subtracted from the practice margin above. | |||
24-month practice margin: 42.5% of net reimbursement (Year 1 42.0%, Year 2 42.7%). Illustrative, modeled — verify against practice data.
Figures are illustrative, modeled — verify against practice data. Values are rounded to the nearest dollar, so row and column sums may differ by $1. Full model available as a companion workbook.
Continuous BP, weight, and glucose surveillance across the CKD and hypertension panels — cellular devices, no app required.
≈ $2.56M in avoided acute cost at $15K each — cost that also flows into CKCC shared-savings performance. Illustrative, modeled — verify against practice data.
27,833 care-team hours of monitoring and documentation lifted off the VBC team — redeployed to top-of-license KCE work.
Recurring monthly professional-fee volume with billing-grade documentation behind every claim.
Because TNG already runs protocols and a monitored panel, launch is a migration: your existing hypertension RPM patients move onto cellular devices and 24/7 coverage first, then the funnel opens to the full CKD 3b–5 population. CoachCare full service means no new headcount to launch — and your dev team gets its roadmap back.
Native Greenway integration configured; your hypertension-program protocols and escalation rules ported into CoachCare workflows; billing rules mapped for Noridian JE.
Existing in-house RPM patients transitioned to cellular devices and 24/7 monitoring; two on-site enrollment specialists embedded across the highest-volume clinics — zero clinical disruption, immediate billing-grade documentation.
Referral enrollment across all 9 offices for CKD 3b–5 and PCM; VBC team redeploys to titration, education, and KCE metric management.
~1,159 unique patients under management by month 12 (~1,420 program enrollments), on a trajectory to ~2,291 unique patients (~2,809 enrollments) by month 24 — still climbing, well inside the program ceilings; monitored-population data feeding CKCC quality measures and the PY2026 tightened-methodology savings case.
Every number on this page traces to the CoachCare Value Analysis workbook or cited public data.