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Chronic Care Management
Proactive remote monitoring for diabetes and hypertension, in partnership with Unika Health.
Overview
What to expect
AmpleHealth partners with Unika Health to provide continuous remote monitoring for patients managing diabetes and hypertension. Between visits, your care team tracks your vitals and key metrics, catching problems early and adjusting your plan before small changes become big ones.
Chronic conditions are not managed in the exam room. They are managed on the ordinary days between appointments — and the gap between those visits is exactly where blood sugar drifts, blood pressure creeps, and small problems become large ones unnoticed.
This program is built to close that gap. In partnership with Unika Health, we combine medical supervision, remote monitoring, and lifestyle coaching so your numbers are visible to your care team continuously rather than twice a year.
We use this approach for hypertension, diabetes, obesity, and COPD — the conditions where steady, between-visit attention makes the largest difference both to how you feel day to day and to where you end up in five years.
What's included
- Remote glucose & blood pressure monitoring
- Partnership with Unika Health
- Between-visit check-ins from your care team
- Proactive plan adjustments
- Coordinated with your in-office care
What the program includes
Complimentary monitoring devices
Depending on your diagnosis you will receive a blood pressure monitor, a glucose meter, or another device suited to your condition, provided at no cost to you. Accurate tracking should not depend on what equipment you happen to own.
A smart mobile app
Track, store, and review your blood sugar and blood pressure readings in one place. The app turns individual readings into trends and surfaces them in real time, so the numbers inform your daily decisions instead of just accumulating.
A personalized care plan and coaching
You work closely with your care team on a treatment plan built around your life, including nutritional counseling, lifestyle coaching, and medication reminders that keep the plan on track between visits.
Virtual support and telehealth access
On-demand remote support for when a question cannot wait for your next appointment. You reach clinical guidance directly, without scheduling delays.
Extensive educational resources
A full library of articles, videos, and health guides. Understanding your own condition is among the strongest predictors of managing it well, and we would rather you have that than a pamphlet.
Real world results on our patients
A1c control over time
Share of enrolled diabetic patients by A1c category
- Controlled
- Mildly uncontrolled
- Moderately uncontrolled
- Severely uncontrolled
View the data
| Category | Enrollment | 3 months | 6 months |
|---|---|---|---|
| Controlled | 37.5% | 62.5% | 75% |
| Mildly uncontrolled | 25% | 25% | 12.5% |
| Moderately uncontrolled | 25% | 12.5% | 12.5% |
| Severely uncontrolled | 12.5% | 0% | 0% |
Blood pressure control over time
Share of enrolled hypertensive patients by blood pressure category
- Controlled
- Mildly uncontrolled
- Moderately uncontrolled
- Severely uncontrolled
View the data
| Category | Enrollment | 6 weeks | 3 months |
|---|---|---|---|
| Controlled | 54.3% | 61.7% | 79.3% |
| Mildly uncontrolled | 37.8% | 34.6% | 18.6% |
| Moderately uncontrolled | 6.4% | 3.2% | 2.1% |
| Severely uncontrolled | 1.6% | 0.5% | 0% |
These are real outcomes from our own patients. When someone joins our Chronic Care Management program, we check where they stand - then we keep checking.
For our diabetic patients, 37.5% had a controlled A1c at enrollment. By three months it was 62.5%. By six months, 75%.
Blood pressure tells the same story: 54% controlled at the start, 62% at six weeks, and 79% at three months, with the severely uncontrolled group shrinking from 8% to about 2%.
That's what chronic care management is for: regular check-ins, medication adjustments, and a care team watching your numbers between visits.
Why we partner with Unika Health
Unika Health's onsite-plus-online model was designed to bridge precisely the gap described above: the one between what happens in the office and what happens at home. It pairs remote monitoring devices with an easy-to-use mobile app and ongoing nutrition and lifestyle coaching.
For people managing diabetes and hypertension, what that produces is steady, measurable improvement over time rather than the sawtooth pattern of good intentions after each appointment followed by drift. It also tends to lower overall healthcare costs, largely by preventing the complications and hospitalizations that uncontrolled chronic disease reliably causes.
Who this is for
If you are managing high blood pressure, diabetes, obesity, or COPD — particularly if your numbers have been difficult to control, or you have felt alone with them between appointments — this program was built for that.
Your monitoring stays connected to the same team that provides your in-office care, so nothing has to be re-explained and no reading goes to a stranger.
Ready to be seen?
Book online in minutes, or call the office nearest you. New patients are always welcome.