Who is Comara Care built for?

Comara Care is sold to Medicare-heavy practices, ACO pods, GUIDE organizations, and care-management leaders who own the downside when a transition fails.

What does Comara Care use AI for?

Comara Care uses AI to extract tasks, dates, medication changes, missing information, red flags, and follow-ups from messy care artifacts, then routes work for human review.

An older woman and her adult daughter reviewing a discharge paper together at a sunlit kitchen table at home

Post-discharge care management

Close post-discharge care gaps, with evidence attached.

Q: What does Comara Care help care teams do?

Comara Care helps Medicare care teams close the loop after discharge, with patient and caregiver engagement, medication reconciliation, follow-up scheduling, referral closure, and evidence capture.

We help Medicare care teams close the loop after discharge, with patient and caregiver engagement, medication reconciliation, follow-up scheduling, referral closure, and evidence capture.

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Provider-sponsored workflows for care teams, patients, and caregivers across web, apps, SMS, and voice.

The problem

Discharge is chaotic. And outcomes, revenue, and quality get lost in the shuffle.

After discharge, every stakeholder is dealing with a different version of the same problem: the organization carries the financial and quality risk, the care team owns a long list of time-sensitive follow-up work, and patients are trying to navigate one of the most confusing moments in their care journey.

Organizations

Unmanaged transitions create real financial exposure. Fee-for-service groups can leave reimbursable work unbilled when outreach, visit timing, medication reconciliation, and documentation are incomplete. Value-based groups and Medicare Advantage partners feel the impact through avoidable utilization, readmission risk, Stars pressure, and patient experience.

The problem is not one missed call. It is a fragile process where revenue, quality performance, and preventable cost depend on every step happening on time, with evidence.

The product

One closure process that connects everyone.

Comara Care owns the entire discharge process end to end, and drives what needs to happen, who owns it, what is still open, what evidence has been collected, and where the next escalation should go.

Care Teams

Care teams get a daily dashboard for the work that has to happen after discharge: outreach, reminders, medication reconciliation, follow-up scheduling, home health coordination, transportation checks, caregiver communication, and documentation.

Comara Care turns discharge packets, patient responses, caregiver input, and care team notes into structured tasks with owners, due dates, source links, and escalation paths. The goal is not another inbox. It is a cleaner way to know what needs attention, what is already handled, and what proof exists.

Patients & Caregivers

RRina S.

Home · day 2

Hi Rina, we're just checking up on you now that you're home. Are you ready to schedule your follow up appointment with Dr. Jackson?

Care team · 10:14am

Yes, I'm free tomorrow afternoon

Rina · 10:16am

Great, how is 3pm?

Care team · 10:17am

Patients and caregivers get simple instructions and clear support via web, SMS, app, and voice. Comara Care helps them understand what changed, what appointments are coming up, what medications need attention, what symptoms to watch, and who needs to be looped in.

The experience is designed for a confusing moment: multiple instructions, multiple people, and a lot of stress. Instead of expecting families to interpret discharge paperwork on their own, Comara Care gives them simple prompts, reminders, and ways to report barriers before small gaps become bigger problems.

Program Admins

Program admins get info on whether post-discharge work is actually happening across teams, locations, and patient populations. Comara Care gives them a live view of open loops, overdue tasks, escalation patterns, documentation gaps, and evidence status.

Instead of relying on manual audits or scattered reports, admins can see where transitions are breaking down, which workflows need staffing or process changes, and which episodes are ready for review.

How it works

From discharge trigger to completed closure.

1 detect

Detect the transition.

A discharge event, encounter list, uploaded packet, or referral creates an episode with deadlines, missing fields, and the right review path.

2 reach

Reach the right person.

Comara Care verifies patient and caregiver channels, contact preference, relationship, and permission status before outreach scales.

3 structure

Turn instructions into work.

Discharge paperwork, portal screenshots, caregiver notes, and medication photos become structured tasks and review items.

4 escalate

Escalate what stalls.

Failed contact, missing payload, medication discrepancies, transportation barriers, caregiver conflict, and high-risk language route to the approved human owner.

5 close

Produce the closure record.

The episode closes with evidence: what happened, who verified it, what is still open, and what billing, quality, or care-management can review.

The evidence

Close the loop clinically, financially, and defensibly.

Discharge follow-up only matters to the organization when it comes back as timely, source-linked evidence: who was contacted, what happened, what code or quality measure it supports, and what still needs escalation.

~10-15%¹ Typical billed TCM capture remains low across Medicare and provider-population benchmarks.

40-60%² Modeled pilot target once discharge triggers, contact, visit timing, medication-reconciliation status, ownership, and evidence capture are managed in one workflow.

Illustrative operating model for pilot planning. Final performance depends on discharge volume, patient mix, staffing, payer rules, and verified baseline TCM capture.

1. Baseline range references a 2015-2019 Medicare FFS analysis reporting TCM in 10.9% of eligible discharges, plus a 2022 provider-population benchmark reporting 15%. Park et al. Pearl Health

2. Pilot target is a Comara internal planning model, not observed performance. Workflow assumptions map to CMS TCM requirements for timely contact, face-to-face visit timing, and medication reconciliation. CMS MLN

Timely reporting back to the organization

Every discharge should return a daily status: contact attempts, patient response, appointment readiness, medication issues, open barriers, owner, due date, and whether the record is ready for billing, quality, or care-management review.

contact log owner timestamp next escalation

FFS evidence for TCM billing review

For fee-for-service workflows, Comara Care helps assemble the operational evidence needed to review CPT 99495 or 99496: discharge date, qualifying contact within 2 business days, medication reconciliation status, visit timing, complexity signals, and unresolved follow-up work.

99495 · 14-day visit 99496 · 7-day visit 2-business-day contact

MA and Stars quality closure

For Medicare Advantage partners, the evidence packet should support transitions-of-care reporting: admission notification, receipt of discharge information, patient engagement after discharge, and medication reconciliation after discharge.

TRC med reconciliation patient engagement discharge info

Compliance-ready closure record

Each episode should preserve source documents, outreach attempts, patient and caregiver permissions, reviewer actions, failed attempts, escalation decisions, and final disposition so teams can explain what happened later.

source-linked audit trail consent scope final disposition

ROI

Make sure you can see the value.

Use practice-specific discharge volume, eligibility assumptions, payer mix, locality, staffing model, and documentation workflow to estimate potential TCM leakage.

Monthly discharges 120

TCM-eligible share 45%

Captured today 15%

Avg TCM reimbursement $210

Pilot recovery rate 40% Share of today's leakage a focused pilot recovers. 40% is a top-quartile stretch target, not a floor — observed top performers reach roughly 55% total capture.

Payer / risk model

Fee-for-service Value-based / at-risk

Stars/quality and avoided-readmission value accrue to at-risk entities (MA, ACO, GUIDE), not fee-for-service billers. Switch to value-based to model them.

Optional ROI add-ons

Quality / Stars value Add estimated quality upside per closure. MedEx readmission avoidance Add modeled medical-expense savings from fewer readmissions. Care team time savings Add estimated staff time recovered per eligible discharge.

Calculator outputs are planning estimates, not reimbursement promises. Billing decisions remain with the provider and billing team. Reimbursement assumptions are illustrative defaults for this POC and should be replaced with practice-specific, locality-adjusted figures.

Full-capture ceiling theoretical

$136K

Annual TCM if every eligible transition were billed and verified — a ceiling, not a forecast.

Estimated annual leakage

$116K

The gap between eligible transitions and what is captured today.

Illustrative pilot target

$46K

A recoverable slice to test in a focused pilot at your chosen recovery rate — a top-quartile stretch target, not the ceiling.

Estimated total ROI selected add-ons

$46K

Includes the illustrative pilot target plus any enabled quality, MedEx, and staff-time assumptions.

TCM pilot recovery$46K Quality / Stars$0 MedEx readmissions$0 Staff time$0

Trust

Built for BAA-governed provider deployments.

Comara Care is designed for HIPAA-aligned workflows with role-based access, audit logs, source-linked outputs, scoped caregiver permissions, and human review where clinical judgment is required.

Role-based accessScoped to what each role needs to see and do.

Audit logsEvery action recorded for review.

Source-linked outputsEvery claim traces back to its artifact.

Scoped caregiver permissionsPermissioned, logged, and revocable.

Human reviewClinical judgment stays with clinicians.

BAA-governedDesigned for HIPAA-aligned provider deployments.

Final step

We'd love to chat on how we can help.

Start with a real discharge queue, measured staff time, patient and caregiver activation, medication-review workflow, visit scheduling, open-loop closure, and evidence completeness.

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