When Doctors Are On Board — But Patients Still Aren’t Enrolling

Fix My Program Series

Introduction: The Retention Problem

Many practices launch Chronic Care Management (CCM) programs with good intentions and solid operational plans, only to find themselves asking a painful question a few months in: “Why aren’t our patients sticking with the program?” If this sounds familiar, you’re not alone. It’s one of the most common challenges faced by practices operating care management programs. In fact, it’s the leading reason many physicians discontinue these initiatives—dropout rates range from 27% to 29% for Chronic Care Management (CCM) and a staggering 45% to 49% for Remote Patient Monitoring (RPM) programs¹. So, what’s going wrong?

The encouraging news is that this isn’t a participation problem. Patients do care about their health, and the engagement puzzle has already been solved in practices just like yours. What you’re facing is a value problem—and that signals an opportunity to recalibrate your program for long-term success. Like any rational consumer, patients are reluctant to pay for or be inconvenienced by services they don’t find meaningful. Whether it’s the cost of copays or the disruption of frequent phone calls, they’ll disengage if the value isn’t clear and tangible.

This whitepaper dives into the reasons behind this disconnect—and outlines actionable strategies your program can use to fix it.

Introduction: The Enrollment Gap

You’ve done the hard part. Your physicians are aligned. They believe in the value of your care management program. They’re recommending it to the right patients. And yet, enrollment numbers are flat.

What gives?

If this is happening in your practice, you don’t have a people problem. You have a process problem.

This whitepaper unpacks one of the most frustrating breakdowns in care management: when great programs with clinical buy-in fail to get patients in the door. The solution starts by understanding where the enrollment handoff is falling apart.

Section 1: The Invisible Bottleneck

Even when doctors fully support your CCM or RPM initiative, enrollment often breaks down inside the practice.

Why? Because in most clinics:

Physicians are too busy to stop and explain a new program
Nurses are stretched thin with clinical tasks
Enrollment requires someone’s time, attention, and operational bandwidth

You can’t expect care management to grow if the people responsible for enrollment are already overcapacity. And yet, that’s exactly what happens in many practices.

Section 2: What Not to Do

You’ve seen this before:

The provider mentions the program quickly at the end of a visit
A nurse tries to hand the patient a device between other tasks
There’s no consistent follow-up, demo, or patient education

Result: the patient leaves confused or hesitant. Enrollment never happens.

In a fast-moving practice, enrollment must be simple, repeatable, and offloaded from top-of-license staff.

Section 3: The Fix — Delegated Enrollment

The best-performing practices delegate enrollment to dedicated team members.

Here’s what it looks like in the real world:

A cardiology clinic in Alabama created a custom “care management script pad.”

The physician checks boxes for which protocols (CCM, RPM, etc.) the patient qualifies for
That note goes directly to a care management MA
The MA takes the lead from there:
- Unboxes the RPM device (BP cuff, scale, etc.)
- Demonstrates how to use it
- Walks the patient through the setup
- Answers the first round of app questions with the patient

This is care management enrollment done right: personal, hands-on, and delegated to the right staff.

It builds confidence, reduces drop-off, and gets patients onboarded immediately.

Section 4: The Staffing Objection

The most common pushback? “We can’t afford to hire someone just to do this.”

But that’s the wrong frame. The reality is:

You already have staff doing unreimbursed care coordination all day
CCM reimburses ~$62 for the first 20 minutes
RPM reimburses ~$48 for the first 20 minutes

With the right structure, an MA or LPN can generate over $100 per hour in reimbursable care just by doing what they’re already doing—but documented and structured through care management.

Section 5: Building a Simple Enrollment Flow

Use this checklist to build a better enrollment experience:

✅ Provider identifies clinical need
✅ Uses a scripted form or order to trigger follow-up
✅ Care management MA or LPN walks through onboarding
✅ Patient receives initial hands-on setup, device demo, and orientation
✅ Data starts flowing within 24 hours

This kind of process ensures enrollment happens reliably, without pulling physicians off task or confusing patients.

Conclusion: Don’t Let a Good Program Stall Out

If your team believes in care management but patients aren’t enrolling, the problem isn’t your program.

It’s your process.

Build a better handoff. Delegate the right tasks. And make enrollment part of your daily rhythm.

Because great care can’t begin until patients say yes.