Prepared for Baker-Gilmour Cardiovascular Institute · 2026 Strategy Review · Confidential — not for distribution
Cardiovascular Service Line Performance & Optimization · Jacksonville & St. Augustine

The Practice That Pioneered Remote Cardiac Monitoring.
It's Time to Get Paid for It.

Dr. Roy Baker helped adapt NASA telemetry so a moving ambulance could transmit an EKG to the emergency room. Seven decades later, Medicare finally pays — every month — for exactly that idea: continuous remote care for heart failure, coronary artery disease, atrial fibrillation, and hypertension. This is the plan to claim it.

$0
24-Month Net Reimbursement
$0
24-Month Practice Margin
0
Hospitalizations Avoided
0
Active Program Enrollments by Month 24
Since 1953 · Remote Care Is in Your DNA

You Invented This Category. The Modern Version Is Waiting.

Baker-Gilmour is not being asked to adopt someone else's idea. The founder's signature achievements — EKGs transmitted from moving ambulances, cardiac patients in small rural hospitals monitored from metropolitan coronary care units — are the direct ancestors of today's remote physiologic monitoring and chronic care management. The only thing missing is the modern program.

★ 1953

Florida's First Pediatric Heart Physician

Dr. Roy Baker opened his Jacksonville practice in 1953 — the founding of a cardiovascular institution now in its eighth decade of independent practice.

★ NASA-Derived Telemetry

Ambulance EKG Transmission

Dr. Baker helped adapt the NASA technology that monitored astronauts' EKGs into systems transmitting EKGs from moving ambulances to emergency rooms.

★ Remote Monitoring Pioneer

Rural Hospital to Metro CCU

He developed remote cardiac patient monitoring — connecting patients in small rural hospitals to coronary care units in larger metropolitan hospitals.

✓ The Whitespace Today

No Modern Program — Yet

No remote physiologic monitoring or chronic care management program is marketed anywhere on the practice's site today. The founder's category sits unclaimed, in his own practice.

Dr. Kay E. Gilmour — Jacksonville's first female critical care practitioner and the first female Chief of Cardiology at Memorial Hospital — extended that legacy of firsts. The 2026 opportunity is to be first again: the independent cardiology group in Northeast Florida that runs remote care as a governed, margin-positive service line.

The 2026 Payment Shift

Both of Your Anchor Hospitals Now Own Mandatory Episodes

Since January 1, 2026, CMS's Transforming Episode Accountability Model (TEAM) holds hospitals financially accountable for 30-day surgical episode cost and quality. Both hospitals where Baker-Gilmour's cardiologists practice are mandatory participants — and a 2026 billing change makes the operational answer newly reimbursable.

Live Now
TEAM · 2026

Two Named Hospitals, In the Model

HCA Florida Memorial Hospital (CCN 100179) — where a Baker-Gilmour physician directs the electrophysiology laboratory — and Flagler Hospital (CCN 100090) in St. Augustine are both mandatory TEAM participants in the Jacksonville CBSA (27260), model window 2026–2030. Their surgical episodes, including CABG, now reconcile against CMS target prices with 30-day spend and readmissions on the line.

Tailwind
CY2026

Short-Window Remote Monitoring Is Now Billable

New CPT codes 99445 (2–15-day device supply) and 99470 (first 10 minutes of management) remove the 16-day floor that used to block episodic monitoring — making post-discharge and post-procedure windows cleanly billable for the first time.

Your Geography
2 for 2

You Sit at the Episode Source

The Jacksonville office is directly across the street from HCA Florida Memorial; the St. Augustine office sits on the Flagler Hospital campus. The discharges those episodes are judged on walk past your front door — a structural position no other independent group can copy.

Heart Failure
Coronary Artery Disease
Atrial Fibrillation
Hypertension

Hospital TEAM participation verified by CCN against published renditions of the CMS selection list (Aug 2024 vintage); re-confirm both CCNs against the current CMS participant file at decision time.

The Operating Model

One Service Line, Built for a Cardiology Practice

Not a device pilot bolted onto one condition — a named service line with its own P&L and scorecard, run on CoachCare's engine and governed by Baker-Gilmour's physicians, following the Medicare patient between every office visit.

Monitoring Arm — RPM
  • RPM Cellular blood pressure, weight, and pulse-ox monitoring across the heart failure, coronary, atrial fibrillation, and hypertension panels — the continuous early-warning and titration layer.
  • Bridge Structured post-discharge outreach with short-window monitoring (99445/99470) on discharges from your two TEAM hospitals — the billable bridge from episode to office.
  • Extend A natural extension of workflows you already run: Holter and event monitoring, pacemaker, defibrillator, and loop-recorder follow-up.
Management Arm — CCM + PCM
  • CCM Chronic care management for the large majority of Medicare cardiac patients carrying two or more chronic conditions — monthly clinical touch, medication reconciliation, care planning.
  • PCM Principal care management for the single high-risk cardiac condition — cardiology-native management between the acute episode and stability.
  • Engine Enrollment, devices, 24/7 alert triage, care-team outreach, documentation, and billing capture — built once by CoachCare, reused by both arms.
The one coordination rule: RPM stacks with either management code in the same month; CCM and PCM are assigned per patient by condition profile, never doubled. One care plan lives in the practice's Veradigm chart, and every claim is supported by auto-generated documentation.

The CY2026 Billing Stack

ServiceCodesCY2026 MagnitudeCardiovascular Use
Transitional care management99495 · 99496~$200 / ~$280*Every HF and post-procedure discharge from Memorial and Flagler
RPM setup & device supply99453 · 99454 · 99445 (new)~$20 setup · $50.00/mo99445 unlocks the 2–15-day post-discharge window
RPM treatment management99457 · 99458 · 99470 (new)$51.12 + $41.22 add'lMonthly review, titration, escalation
Chronic care management99490 · 99439$65.97 + $50.16 add'lMulti-condition Medicare cardiac patients
Principal care management99426 · 99427$67.57 + $53.69 add'lSingle high-risk condition (HF, resistant HTN) ≥3 months

Dollar figures are CY2026 Physician Fee Schedule amounts auto-resolved for zip 32216 (Florida carrier 09102, locality 99), as used in the Value Analysis below. *TCM shown at illustrative national non-facility magnitude — not included in the modeled forecast. Verify all rates against the current fee schedule.

Connective Tissue

One Service Line, Every Value Layer

The same infrastructure — enrollment, devices, alerts, outreach, documentation, billing — is the connective tissue for the TEAM episodes your hospitals now own, and for every other lever the practice cares about. Build once, reuse everywhere.

A Standalone Recurring P&L
$1.86M modeled net reimbursement and $630K practice margin over 24 months — recurring, subscription-like professional fees from the panel you already manage, margin-positive from month two, with enrollment staffing funded by CoachCare.
TEAM Episode-Cost Performance
Discharge outreach plus first-14-day monitoring on every high-risk discharge from HCA Florida Memorial (CCN 100179) and Flagler Hospital (CCN 100090) moves 30-day spend and readmissions — the exact terms on which those hospitals' episodes are now reconciled. The group that runs this program becomes the partner both hospitals need in the model era.
Device-Clinic Modernization & the Renal-Denervation Lane
Your EP program already generates a device-follow-up population — pacemakers, defibrillators, loop recorders, Holter and event monitors. A modern remote-monitoring backbone upgrades that workflow, and the hypertension RPM panel it creates is the same blood-pressure infrastructure on which renal denervation referral and evidence pathways are being built — an open lane in this market.
The Quality Halo
Seven decades of independent reputation, defended between visits. Continuous post-discharge care protects readmission performance, patient loyalty, and the hospital leadership roles your physicians hold — the halo that anchors referrals in a consolidating market.
In the Chart You Already Use

Built to Run With Your Veradigm Environment

Baker-Gilmour runs a Veradigm ambulatory environment, with patients already using the FollowMyHealth portal. CoachCare's integration catalog includes Veradigm: the program is designed to work from the chart your team already lives in, not beside it.

Enroll

From the Chart

Eligible patients are identified and enrolled from practice data — no separate registry to maintain, no new system for your staff to learn.

Monitor

Vitals Flow Back

Cellular device readings and care-team documentation return to the practice as structured data — a continuous record between visits, not a stack of faxed PDFs.

Document

Compliance Built In

Time logs, care plans, and consent capture are generated automatically to the standard each code family requires.

Bill

Claims-Ready Every Month

CoachCare's billing engine assembles claim-ready detail for every enrolled patient, every month — the capture-rate discipline that decides program economics.

Integration scope and the exact Veradigm ambulatory product configuration are confirmed in contracting; patients keep the FollowMyHealth experience they already know.

CoachCare Value Analysis · Modeled for Baker-Gilmour

The Value Analysis

A 24-month forecast for the practice: an estimated 2,200-patient Medicare panel across both offices, six referring providers plus a dedicated on-site enrollment specialist funded by CoachCare, CY2026 rates auto-resolved for zip 32216 (Florida carrier 09102, locality 99). TEAM episode upside and avoided-readmission savings are not in these numbers — they are upside on top. All figures are illustrative and modeled; verify against practice data.

Enrolled Patients Under Active Remote Care

Monthly active census by program · physician referrals (5/provider/mo, 70% acceptance) + 1 on-site enrollment specialist (80/mo), net of discharges

Monthly Economics — Revenue, Fees, Margin

Net reimbursement (after denials and coinsurance bad debt) vs. CoachCare fees · margin turns positive in month two

24-Month Net Reimbursement Mix

$1.86M total across the three-program cardiology stack

The Financial Summary

ProgramYear 1Year 224-Month
RPM net reimbursement$239,993$449,170$689,163
CCM net reimbursement$250,912$509,668$760,580
PCM net reimbursement$100,256$314,562$414,818
Total net reimbursement$591,162$1,273,400$1,864,561
Practice margin (after fees)$192,262$437,685$629,947
Includes an on-site enrollment specialist staffed at CoachCare's expense — embedded value already reflected in the fees above, never deducted from your margin.

Figures are illustrative and modeled — verify against practice data. Full model available as a companion workbook.

Scenario Explorer — Build Your Own Forecast

Adjust the assumptions and watch the 24-month forecast recompute live. Directional, calibrated to the CoachCare Value Analysis engine — the companion workbook remains the source of truth. Modeled panel: 2,200 (estimate; plausible range 1,800–2,900).
24-mo net reimbursement
$1.86M
24-mo practice margin
$0.63M
Enrollments at month 24
1,152
Hospitalizations avoided
~48
34,819

Billed Claims / Units

Recurring, subscription-like professional-fee volume over 24 months.

75,708

Physiologic Readings

A continuous clinical picture of the HF, CAD, AFib, and HTN panels between visits.

~48

Hospitalizations Avoided

≈ $721K in avoided acute cost at $15K per admission — and direct relief on your hospitals' 30-day episodes.

8.2

FTE-Years Absorbed

17,101 care-team hours of monitoring, outreach, and documentation handled by the service line.

Implementation

Chartered in 30 Days.
Enrolling by Day 45.

CoachCare operates as the service line's engine — enrollment outreach, device logistics, 24/7 monitoring, and billing-ready documentation — while Baker-Gilmour's physicians govern protocols and every clinical decision. Full-service delivery means launch requires no new practice headcount: the on-site enrollment specialist is staffed at CoachCare's expense, and your medical assistants and front desk keep their current workflow.

Schedule the Working Session
0–30 Days

Charter the Service Line

Named physician owner, P&L, scorecard; Veradigm integration and billing configuration; protocol sign-off for the HF, CAD, AFib, and HTN pathways; panel validation against practice chart counts.

31–90 Days

Anchor Cohorts First

Heart failure and post-procedure discharges from Memorial and Flagler, plus the device-clinic population — first billable enrollments by day 45, outreach within two business days of discharge.

91–180 Days

Both Offices at Full Enrollment

Jacksonville and St. Augustine panels enrolling to ceiling pace; hypertension cohort deepens; monthly scorecard — census, capture rate, revenue per patient-month, readmission signal — to practice leadership.

181–365 Days

The Episode Partnership

Program results packaged for your hospital partners: documented 30-day support on their reconciled episodes — the evidence that makes Baker-Gilmour the indispensable cardiology partner in the model era.

About CoachCare

The Experience to Get It Right

The service line described on this page runs on infrastructure already proven at national scale.

500,000+

Patient Management Expertise

Over 400 managed conditions for 500,000+ patients.

10,000+

Clinician Success

Providers committed to remote care excellence.

1,000+

In-Market Success

Successful program implementations.

5M+

Operational Excellence

Care plan coding and billing generating over 5 million claims.

100M+

Unprecedented Scale

Over 100 million vitals recorded and 4 million+ care actions enabled.

Transparency

Assumptions & Sources

Every number on this page traces to the CoachCare Value Analysis workbook or cited public data. The key assumptions:

Population sizing
  • ~2,200 Medicare patients estimated for the practice, derived from practice-level Medicare claims volume. This is a modeling estimate, not a chart count — plausible range 1,800–2,900; validate against practice chart counts in discovery.
  • Full panel in scope from Year 1; program eligibility 60% (RPM), 70% (CCM), 70% (PCM); enrollment conversion 30% (RPM), 25% (CCM), 25% (PCM) — yielding enrollment ceilings of 396 (RPM) and 385 (CCM and PCM) active patients. RPM reaches its ceiling in month 12 and CCM in month 13; PCM does not reach its ceiling within 24 months (~371 active at month 24), leaving further upside.
  • Enrollment pathways: physician referral (5 referrals/provider/month across 6 providers at 70% acceptance), one on-site enrollment specialist at 80 enrollments/month staffed at CoachCare's expense, and a telephonic outreach layer.
  • "Active program enrollments" is the sum of RPM, CCM, and PCM enrollments — not unique patients, since most enrolled patients participate in more than one program.
Rates & revenue mechanics
  • CY2026 Physician Fee Schedule rates auto-resolved by MAC carrier/locality for zip 32216 (Florida carrier 09102, locality 99): e.g., 99457 $51.12 · 99458 $41.22 · 99454 $50.00 · 99490 $65.97 · 99439 $50.16 · 99426 $67.57 · 99427 $53.69. Denial, coinsurance bad-debt, and 1.5% monthly attrition assumptions are itemized in the companion workbook.
  • Month-1 economics are net-negative (−$4,031) because one-time implementation and EMR-integration setup land before census builds; the program is margin-positive from month two onward.
  • CoachCare fees are held at standard list pricing — the modeled 24-month practice margin is 51% with no negotiated discount assumed.
  • Code-level capture assumptions (share of managed months billing each code) are itemized in the companion Value Analysis workbook.
Verified facts & vintages (July 2026)
  • Practice history — founding in 1953, the NASA-derived ambulance EKG telemetry work, remote monitoring of rural-hospital cardiac patients, and Dr. Gilmour's firsts — is sourced from the practice's own website (fetched July 2026).
  • TEAM: Jacksonville CBSA 27260 appears on the CMS 188-CBSA selection list (FY2025 IPPS Final Rule). HCA Florida Memorial Hospital (CCN 100179) and Flagler Hospital (CCN 100090) each appear as participant hospitals under CBSA 27260 on published renditions of the CMS selection list (Aug 2024 vintage); hospital identities cross-checked against CMS Care Compare. Re-confirm both CCNs against the current CMS TEAM participant file at decision time. Model window: Jan 1, 2026 – Dec 31, 2030.
  • New CY2026 RPM codes 99445 and 99470: CY2026 Physician Fee Schedule.
  • EMR: Veradigm environment confirmed via commercial intelligence and the practice's FollowMyHealth patient portal; the exact ambulatory product configuration is confirmed in contracting.
  • Program whitespace: no remote physiologic monitoring or chronic care management program is marketed on the practice's website (reviewed July 2026); remote device-clinic monitoring status was not publicly determinable.
  • Hospitalizations avoided are modeled from monitored patient-months and valued at $15,000 per avoided admission.