(281) 990-7000
Toll Free: (877) 907-0007
Fax: (281) 990-7626

Chronic Care Management

Chronic Care Management

Chronic Care Management (CCM) is a PCP-focused Medicare program created to decrease hospitalizations and slow the progression of chronic diseases. It is designed to help clients improve health outcomes through monthly monitoring by trained clinicians.

The CCM program provides the following benefits:

  • 24/7 access to an on-call registered nurse
  • Individualized care plans to address medical, safety and lifestyle choices that inhibit healing
  • Monthly calls to patients to track changes in health and monitor goals in care plan
  • Notification to PCP of changes in health between visits
  • Reduced medication errors Reduced side effects from duplicate medications
  • Identification of assistive devices to improve safety and overall well-being
  • Training materials specifically targeted to a patient’s individual medical needs
  • Identification of community resources to ensure patients are able to follow doctors’ recommendations

Denson Home Health, Inc. does not discriminate based on race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability or genetic information.


  • 201 Flint Ridge Rd, Ste 200
  • Webster, TX 77598
  • Phone: (281) 990 – 7000
  • Fax: (281) 990 – 7672