For providers, health plans, institutions & ACOs
Transforming practices for better quality, better outcomes, and better financial performance.
Value-based care isn’t coming. It’s here. And the practices that thrive will be the ones whose operations, data, and care teams are aligned to it.
- Advanced Primary Care Managementsvc/apcmPhase: Execute
- Chronic & Principal Care Managementsvc/ccmPhase: Design
- Transitional Care Managementsvc/tcmPhase: Monitor
- Annual Wellness Visitssvc/awvPhase: Access
- Remote Monitoringsvc/rpm-cgmPhase: Design
- Behavioral Health Integrationsvc/bhiPhase: Execute
Results at a glance
Numbers from the work, not from a brochure
What changed in our prior engagements — client names withheld; references available on request.
- Multi-site provider network
25%
PMPM improvement and 25% MLR reduction under ACO/MSSP and value-based contracts
- 30+ provider medical group
40%
Reduction in hospitalizations and readmissions after CCM and RPM redesign
- Public-health transformation program
10–15%
Quality-measure improvement across a 26-practice portfolio, plus +15% operational efficiency
- Care-management company
+30%
Program revenue and 30% fewer readmissions from a from-zero CCM, RPM and preventive launch
- Payer operations
15%
Fewer EDPS rejects through submission oversight and process documentation
- Care transitions
40%
Reduction in care gaps and 10% fewer readmissions for a high-risk population
- CCM and RPM operations
20
Person care-coordination team hired, trained and led; +20% care-management revenue
- Multi-site provider network
12%
Fewer avoidable ADT events and +5% member incentive revenue
Figures are from prior engagements and employment. Every organization is different; projections for a new client are modeled from that client's own data before anything is built.
Read the full engagements: the situation, what was done, what changed →
Connected care
Patients, providers and payers, connected by the same work
Care gaps stay open when workflows never close them. We redesign care delivery with your team, then capture the result as structured, coded data that payers can see. Select a node to see what flows on each connection.
Nelangie Cares ↔ Patients
What reaches patients
- Care plans and monthly care management, with documentation built for review (CCM / PCM).
- Follow-up after discharge: contact within two business days, a visit within 7 or 14 days (TCM).
- Readings collected between visits and acted on: hypertension, heart failure and diabetes (RPM, CGM).
- Screening, warm handoffs and collaborative care for behavioral health (BHI / CoCM).
- 01
Better outcomes
- Care gaps closed across preventive, chronic & behavioral health
- Fewer avoidable ED visits and readmissions
- 02
Revenue that’s earned, captured
- Risk adjustment revenue that reflects true complexity
- Billable CCM / AWV / TCM services captured
- 03
Less burnout for care teams
- Workflows redesigned around how your team actually works
- Care team roles optimized — everyone at top of license
Self-check
Where is value leaking?
Value-based care isn’t coming. It’s here. Flag the signals you recognize and the goals you’re working toward — we’ll route you to the services and programs built for them.
Readout
Awaiting signals
Select one or more signals or goals to see the recommended services and CMS programs.
What we do
Four service pillars. One connected strategy.
Each pillar stands on its own — together they compound into durable value-based performance. Documentation integrity and EHR optimization make the gains stick.
Services shown in default order.
- 01 · svc/quality
Practice Transformation & Quality Improvement
- 02 · svc/risk-adjustment
Risk Adjustment & Coding Optimization
- 03 · svc/cdi-coding
CDI Review & Coding
- 04 · svc/complex-care
Complex Care & High-Utilizer Management
- 05 · svc/value-based
ACO & Value-Based Performance Enablement
- 06 · svc/ehr-optimization
EHR Enhancement & Optimization
CMS program design
Programs designed, launched and run inside your practice
We design the CMS programs that fund coordinated care — eligibility, consent, workflows, documentation and clean claims — inside the EHR and the visits you already have.
The people behind the measures
Better care for patients. A lighter load for the teams who give it.
01 · Personalized careCare plans built around the patient in front of you
Care plans with structured follow-up, and monthly care management that keeps each plan current.
Chronic & Principal Care Management →Advanced Primary Care Management →Photo: Vitaly Gariev / Unsplash
02 · Less burnoutWorkflows redesigned around how your team actually works
Everyone working at the top of their license, with templates that capture measure-ready data without adding time to the encounter.
Practice Transformation & Quality Improvement →EHR Enhancement & Optimization →Photo: RDNE Stock project / Pexels
03 · ConnectedFollow-up that never depends on someone remembering
Every ED visit and discharge starts the same clock: outreach within 48 hours and TCM contact within two business days.
Transitional Care Management →Complex Care & High-Utilizer Management →Photo: Kaboompics.com / Pexels
Stock photography for illustration. The people shown are not Nelangie Cares clients, patients or staff.
The value loop
Connecting Data → Transforming Care
Plenty of firms hand you a report. We build the operating system — with you, inside your practice. Select a stage to see what we do there.
Transforming Care Delivery.
Stage 01 / Data
Clinician-trained eyes on your data
We read data the way clinicians read vital signs — with precision, urgency, and a sense of what the numbers are quietly trying to say.
We build shared insight from your quality, risk, and utilization data — and target the highest-impact gaps first.
Our framework
Access. Design. Execute. Monitor.
The four disciplines in our name — and the operating rhythm behind every engagement.
Phase 01 · Access
Connect and diagnose through data
We build shared insight from your quality, risk, and utilization data — and target the highest-impact gaps first.
The gate between phases is a signed artifact, not a status meeting.
↻ A continuous loop: Data → Conversations → Workflow Assessment → Redesign → Pilot → Reliability → back to Data. Nothing is built until the baseline is signed.
Who we serve
Built for providers, institutions & ACOs
Wherever you sit in the value-based care ecosystem, the framework adapts to your context.
Physician practices
Independent and group practices seeking stronger quality performance, risk capture, and operational efficiency.
A one to three provider practice carries the same reporting obligations as a fifty provider group, with none of the infrastructure.
Where we focus
Starting point
A two to three week assessment
Your build, your measure performance and your capture rates, baselined — with a ranked list of what to fix.
For health plans
Move the measures you are rated on, inside the network that earns them.
Stars, HEDIS, risk adjustment and utilization are reported by the plan but decided in network practices and facilities. We work alongside those providers, in the EHRs they already use, so the care that happens is documented, captured and visible to you.
Plan types
- Medicare Advantage plans
- Medicaid managed care
- Commercial & ACA plans with value-based networks
“Your ratings are earned in exam rooms you do not run.”
In your network, we
Close care gaps at the visit, and make the result visible to the plan.
- Map which measures each network program pays on, with a gap analysis against current benchmarks
- Close gaps through EHR alerts, standing orders for labs and screenings, and quarterly outreach
- Report results as CPT II codes on the claim or through supplemental data feeds, checked monthly
- Work in the payer and quality platforms your network already uses, such as UnitedHealthcare and Optum portals, Cozeva and Availity
- Run Annual Wellness Visit campaigns that support several quality and chronic care measures at once
What the plan sees
- Results arriving as structured, coded data your measure calculation can read, not values left in a progress note
- Gap closure and HEDIS performance tracked monthly by practice and by provider
Payers differ in which supplemental codes they accept; we confirm the rules with each plan.
How an engagement works with a plan
The same Access → Design → Execute → Monitor method, run across your network.
01 · Access
Assessment
Agree the measures, contracts and network practices in scope, then baseline gaps, risk capture and utilization from plan and practice data.
Gate Signed baseline
02 · Design
Network plan
Choose the practices and workflows that go first, and write the documentation standard each practice builds to.
Gate Signed build plan
03 · Execute
Network rollout
Pilot in a few practices inside their own EHRs, then extend across the network after a go / no-go decision.
Gate Release acceptance
04 · Monitor
Monitoring
Monthly provider-level reporting to the plan and the practices, feeding the next baseline.
Gate Renewal or handoff
A Business Associate Agreement is executed before we see any protected health information. Network practices remain the billing party; we do not submit claims.
Talk to us about your network
Tell us which measures, contracts and practices matter most. We will tell you honestly where we can help first.
FAQ
Answers for physician practices
About Nelangie CaresWhat does Nelangie Cares do?
We are a value-based care consulting firm. We help healthcare organizations improve quality performance, document risk accurately, reduce avoidable utilization and run CMS care-management programs, so the care they already deliver is captured, measured and paid for.
About Nelangie CaresWhat is value-based care?
Value-based care pays for outcomes and quality rather than the volume of services. Performance on quality measures, risk adjustment and utilization increasingly determines what an organization earns, through programs such as Medicare Advantage Star Ratings, MIPS, ACO shared savings and plan incentive contracts.
About Nelangie CaresWhat makes your approach different?
We work inside your organization, not beside it. We build in the EHR you already use, pilot before we scale, report at the provider level where variation actually lives, and tie every piece of work to the measures and contract terms you are paid on. We scope to what can be finished, and we tell you when something is not worth doing.
About Nelangie CaresWhat experience does your team bring?
Our team brings clinical experience in primary care and preventive medicine, together with medical coding, EHR and EMR enhancement and optimization, healthcare analytics, and hands-on work across CMS quality, risk adjustment and care-management programs.
Who We ServeWho do you work with?
Physician practices of every size, large groups and MSOs, FQHCs and community health centers, health systems and clinically integrated networks, ACOs and risk-bearing entities, nursing homes and post-acute providers, and health plans.
Who We ServeAre your services right for a small or solo practice?
Yes. A small practice usually does not need everything at once. We focus on the few changes that move its actual results and scope the work so it can be finished in one engagement rather than becoming a permanent project.
Next step
Are you ready to transform care delivery?
Let’s build a strategy for better outcomes, stronger workflows, and improved value-based performance — starting with a conversation.