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.
New monthly revenue; zero effort
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!
Built-in resource finder for real impact
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 487: Screening for SDOH.
- Risk coding support through Z-code capture.
- Better outcomes = stronger value-based contracts.
Scalable, sustainable, and fully compliant
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)
We provide a hybrid staffing + technology model
GroundGame.Health offers an ideal combination of human interactions, supported by comprehensive tech.
Staffing
Trained community health workers who engage Medicare members remotely.
Platform
Time tracking, audit logs, SDOH resource referrals.
Billing support
Export-ready documentation.
Outreach
Multichannel, including text messaging, calls, email, and conventional mail workflows.
Closed loop
Referral tracking and outcome documentation.
How we’ve solved the social needs of patients
Real people, real stories.
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.
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.
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.
