Who We Serve / PROVIDERS

Community Health Integration Services

Ground Game Health helps your practice unlock recurring Medicare revenue through community health integration (CHI) services — using our trained care team, integrated technology, and outcomes-driven approach.

A physician, visible to the camera, with her hand on the shoulder of another person whose back is to the camera, suggesting empathy and care.

New monthly revenue; zero effort

A smiling older woman in a wheelchair, holding the hand of a nurse whom we see from the rear.

Enjoy a new source of incremental revenue for your practice, with no investment, no extra staffing, and no changes in workflow.

  • We enroll, manage, and document services for your Medicare patients.
  • Earn $200* per patient per year (using codes G0019 and G0022) through incident-to billing.
  • No physician time required — we operate under general supervision.
  • Typical CHW supports 100–150 members/month.

No workflow disruption

Adopting the GroundGame.Health CHI solution in your practice doesn't disrupt your existing workflows.

  • No platform logins or staffing changes required.
  • All services are provided outside your clinical schedule.
  • You can stay focused on clinical care — we handle the rest!
A nurse working at a computer in a doctor's office. She's smiling.

Built-in resource finder for real impact

A picture showing two people. One has their back to the camera, while the other is visible and smiling, holding a box of groceries, suggesting the concept of food assistance.

Our Implify™ platform integrates resource finding and tracking, from initial intervention to case closure.

  • Our CHWs use Implify to connect patients to food, housing, behavioral health, transportation, and more.
  • Closed-loop tracking proves follow-through and outcomes.

Boost MIPS and risk adjustment performance

Adopting the GroundGame.Health CHI solution in your practice doesn't disrupt your existing workflows.

  • CHI services support key quality measures:
    • MIPS Measure 486: Screening for SDOH.
    • Risk coding support through Z-code capture.
  • Better outcomes = stronger value-based contracts.
A physician using a laptop computer, looking at metrics shown on its screen.

Scalable, sustainable, and fully compliant

A smiling woman wearing a telephone headset, looking at a computer sitting on the desk in front of her, suggesting support, help, and/or outreach.

We couple a proven platform with a team of professionals dedicated to your success.

  • General supervision model (no direct physician time required).
  • HITRUST-certified and HIPAA-compliant platform with time tracking, documentation and audit logging.
  • Dedicated Client Success Team.

A revenue model that’s aligned with reimbursement

Use applicable Medicare CHI codes G0019 and G0022 to record interactions and set them up for Medicare reimbursement.

  • CPT Code G0019: For first 60 minutes
  • CPT Code G0022: For each additional 30 minutes
  • Paid under general supervision (no direct physician time needed)
A medical professional typing on a small wireless computer keyboard. We see the professional's hands and arms, and a portion of the computer screen.

We provide a hybrid staffing + technology model

GroundGame.Health offers an ideal combination of human interactions, supported by comprehensive tech.

Icon depicting three human heads, suggesting a group of people.

Staffing

Trained community health workers who engage Medicare members remotely.

An icon that suggests a circuit design and technology more broadly.

Platform

Time tracking, audit logs, SDOH resource referrals.

Icon depicting a document. A dollar sign is visible on the document, suggesting billing and/or invoicing.

Billing support

Export-ready documentation.

Icon depicting a clipboard. On the clipboard is a portion of a classic football play approach, suggesting a plan of execution, or steps of a process.

Outreach

Multichannel, including text messaging, calls, email, and conventional mail workflows.

Icon of a person surrounded by arrows in a circular pattern, suggesting the concept of personalization.

Closed loop

Referral tracking and outcome documentation.

How we’ve solved the social needs of patients

Real people, real stories.

A blonde woman with a slight smile, looking at the camera. She appears to be in her 20s or 30s, and has a young boy on her back, with his arms wrapped around her, with a wide smile.

Roberta*

Roberta, a single parent of young son, struggled to find stable housing and enough food. When her health plan contacted her about routine exams that she’d missed, her situation came to light, and she was referred to GroundGame.Health. Our care coordinator, Tiara, worked to identify and provide resources to Roberta. She said that Tiara was “giving me a leg up in the game” by ensuring that she now had secure housing and reliable food support.

A photo of a woman wearing glasses, looking out a window.

Chantel*

Chantel is a 39-year-old woman who has noted noticeable changes in her eyesight. Additionally, she's eager to engage with a dietician or nutritionist to establish a healthier lifestyle. We helped Chantel find an optometrist covered by her insurance so she could receive an eye exam. We also directed her to a local resource that could help her work toward a healthier diet and better lifestyle choices.

An older man with gray hair, standing, while holding onto a rollator.

Randy*

Randy, 75, had mobility issues, as his rollator was both too small, and in disrepair. Also, his caregiver was unreliable, and his cell phone was not working — making it impossible to seek help. Our care coordinator intervened, arranging a new rollator prescription, and helping source a new one. She intervened with the care agency on his behalf, and also arranged for a new phone. The support has led to a much better quality of life for Randy.


* The names and likenesses of individuals and the details of their experiences with GroundGame.Health have been altered to protect individual privacy.