ChenMed, a physician-led and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to be America's leading primary care provider, transforming care of the neediest population. For patients that are unable to come to the office-in hospital, SNF, LTC or homebound, PCP will engage with the transitional care team and others including case managers, acute and transitional-care physicians, and other resources that may be available depending on the market.