Scaling Care Management across Healthstar Physicians, a large multi-specialty group

Background

Healthstar Physicians, P.C. is a multi-specialty group serving East Tennessee with 130+ providers across 30+ locations. For over 30 years, Healthstar has been dedicated to delivering high-quality, community-focused healthcare with a strong emphasis on chronic disease management and preventive care.

As the burden of chronic conditions increased and value-based care models expanded, Healthstar sought innovative ways to extend care beyond the clinic walls while keeping provider workflows simple and sustainable.

Problem

With a broad provider network and diverse patient population, Healthstar was well positioned to deliver high-quality care. But as they looked to expand Remote Care Management programs, scaling consistently across many locations became increasingly complex. Each site had unique workflows and patient needs, staff capacity was already at a premium, and leadership wanted to ensure programs were delivered in a way that was sustainable, compliant, and financially sound. To move forward, Healthstar needed a scalable, reliable approach that could streamline processes, support staff, and engage patients consistently across the organization.

Key considerations in scaling:

• Staff capacity: In-house teams were balancing direct patient care with the added demands of monthly calls, care plans, and follow-ups.
• Billing processes: Manual checks and coding created inefficiencies that could limit reimbursement and slow adoption.
• Patient engagement: Sustaining regular monthly touchpoints across large populations required more dedicated focus.
• Scalability: Growth across locations highlighted the need for consistent systems and added support.
• Financial opportunity: Leadership saw that a more streamlined model could both enhance patient outcomes and ensure programs were financially sustainable.

Partnership with Medsien

Healthstar selected Medsien to implement and manage its Remote Care Management programs, including Chronic Care Management (CCM) and Principal Care Management (PCM. Medsien’s solution was designed to address the full scope of challenges—technology, staffing, workflows, and compliance—in one unified model.

Key reasons for selection:

• Deep EHR integration with athenahealth (used by Healthstar), enabling seamless enrollment, structured documentation, and automated billing. The integration minimized disruption and allowed providers to see CCM/PCM activities directly in their existing system of record.
• Scalable staffing model: Medsien provided dedicated care partners trained to conduct monthly patient interactions, create and update care plans, and ensure all documentation met CMS standards. This eliminated the need for Healthstar to hire, train, and manage additional staff internally.
• Proven billing intelligence: Medsien’s platform automated eligibility checks, reconciled coding, and ensured timely, accurate claims submission. This significantly reduced administrative burden while capturing revenue that previously slipped through the cracks.
• Training and change management: Medsien supported Healthstar with onboarding, training, and ongoing coaching for both providers and administrative staff. This helped align workflows across locations, reduce variability in processes, and ensure every team was confident in delivering CCM/PCM consistently.

Results

Since launching with Medsien, Healthstar has seen transformational results across multiple dimensions:

• High patient engagement: Over 93% of enrolled patients consistently complete monthly CCM and PCM interactions, creating reliable, ongoing touchpoints for at-risk populations.
• Improved patient outcomes: Patients are proactively redirected back to Healthstar offices rather than relying on emergency departments, leading to fewer avoidable ER visits and hospitalizations. Medsien’s structured escalation process also resulted in more timely office visits, giving providers opportunities to intervene earlier and strengthen continuity of care.
• Revenue growth: Medsien unlocked incremental annual revenue directly from CCM and PCM, capturing previously missed opportunities and demonstrating the financial sustainability of remote care management.
• Operational efficiency: Automated billing and documentation workflows freed up 20–25 staff hours per clinic per month, allowing Healthstar teams to focus on direct patient care instead of paperwork.
• Compliance & quality: Claim denial rates dropped to under 1%, supported by structured documentation and Medsien’s audit-ready platform, giving leadership confidence in compliance with CMS regulations.

Scalable success: Medsien successfully implemented programs across multiple diverse locations and specialties with minimal workflow disruption, proving that care management could be scaled effectively in a large, multi-specialty setting.

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Key Takeaways

The Healthstar case demonstrates how a large multi-specialty group can successfully scale CCM and PCM with the right partner. By leveraging Medsien’s integrated technology, staffing, and billing expertise, Healthstar transformed challenges into measurable gains—improving outcomes, ensuring compliance, and unlocking new revenue streams—all while maintaining focus on patient care.

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