Medicare will pay you to keep patients well. Most practices miss it.

Medicare will pay your practice to keep chronically ill patients out of the hospital, so why do most practices leave that money unused? Rachel Yates, a registered nurse and health care executive, joins to explain two reimbursement programs Medicare introduced in 2024, Community Health Integration and Principal Illness Navigation, and why two years later most practices still are not using them. This episode is based on her article "Patients pay when Medicare care coordination codes go unused," published on KevinMD. You will hear who actually qualifies, the patients you already see every day who keep cycling back through the ED, and how a single missed medication instruction can turn into a preventable readmission. Rachel makes the case that this is clinical care, not a billing add-on, and that the work can be delivered by contracted nurses under your supervision without piling more onto your existing staff. She walks through what a real between-visit coordination relationship looks like and why a 15-minute appointment was never going to fix everything. She lays out who qualifies, why the codes go unused, and the decision every practice now has to make.

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