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Chronic Care Management in Katy, TX

Smiling woman using a glucometer to monitor her health, highlighting compassionate chronic care management services in Katy, TX.
Managing chronic conditions such as high blood pressure, diabetes, obesity, and asthma requires a dedicated healthcare approach. At Macie Medical in Katy, TX, we specialize in providing complete Chronic Care Management (CCM) services to adults and seniors to help them live a healthier, more fulfilling life.

If you are dealing with chronic conditions like high blood pressure, diabetes, obesity, asthma etc. and need support, Macie Medical provides the support, guidance, and expertise you need for effective chronic care management. Our lead physician Dr Judith Aniekwena is double board certified in internal medicine and obesity medicine. Book your appointment today to receive a tailored care plan designed for you. 

What Is Chronic Care Management (CCM)?

Chronic Care Management is a specialized healthcare service designed to help patients with ongoing chronic conditions to manage their symptoms, improve their quality of life, and prevent complications. Unlike routine care, CCM focuses on continuous monitoring, education, and coordinated support to prevent complications and improve long-term health.This service includes:
  • Regular monitoring of your health status.
  • Development of personalized care plans.
  • Monitoring and managing medications
  • Coordination of care with specialists and healthcare providers.
  • Education on lifestyle changes to improve your health.

As a result, patients experience improved outcomes and fewer hospital visits.

Benefits of Chronic Care Management

Choosing Macie Medical for chronic care management in Katy, Texas, offers significant advantages:
  • Improved Quality of Life: Effective symptom management enhances daily comfort and functionality.
  • Complication Prevention: Regular monitoring reduces risks of serious health events like strokes or heart attacks.
  • Personalized Support: Customized care plans address your unique health needs and lifestyle goals.
  • Continuous Monitoring: Monthly check-ins ensure your treatment evolves with your health.
  • Empowered Decision-Making: Counseling for chronic illness in Katy equips you with tools to manage your condition confidently.

Our care management services in Katy help you stay active, independent, and in control of your health.

Our Chronic Care Management Program in Katy, TX

Macie Medical’s chronic care management program is patient-centered, focusing on comprehensive evaluations and ongoing support. We integrate advanced technology through partnerships with Withings and Freestyle Libre for real-time health tracking, ensuring accurate and timely care. Our program includes:

  • Comprehensive Health Evaluations: Assess your medical history, current conditions, and lifestyle factors.
  • Regular Check-Ins: Monthly in-person or telehealth visits to monitor progress and adjust care plans.
  • Specialist Coordination: Seamless collaboration with specialists for advanced care needs.
  • Patient Education: Guidance on managing conditions like diabetes, hypertension, or asthma through counseling for chronic illness in Katy.


Our primary care physician in Katy team is committed to delivering measurable results for patients across Katy and Houston.

Chronic Care Services for Adults and Seniors

Our chronic care management in Katy, Texas, is tailored for adults and seniors managing conditions such as:

  • Diabetes Management: Blood sugar monitoring, medication adjustments, and dietary counseling.
  • Hypertension Control: Regular blood pressure checks and lifestyle recommendations to prevent heart disease.
  • Obesity & Weight Management: Expert guidance from Dr. Aniekwena, a board-certified obesity medicine specialist, for sustainable weight loss.
  • Asthma & COPD Care: Personalized action plans to reduce flare-ups and improve respiratory health.
  • Arthritis Support: Pain management and mobility strategies to enhance quality of life.
  • Preventive Screenings: Routine lab tests and diagnostics to detect complications early.
  • Nutritional Counseling: Counseling for chronic illness in Katy with personalized diet plans to support overall health.


Our best primary care physicians in Katy ensure comprehensive care that addresses all aspects of your chronic conditions.

How Our CCM Program Works

Our chronic care management program is structured to provide continuous, personalized support:
  • Initial Assessment: A thorough evaluation of your health history, current conditions, and goals by a primary care physician in Katy.
  • Personalized Care Plan: A customized care plan outlining treatment strategies, health goals, and lifestyle recommendations.
  • Assigned Care Coordinator: A dedicated coordinator ensures seamless communication with specialists and other providers.
  • Advanced Technology: Free access to devices like Withings and Freestyle Libre for real-time monitoring of vital signs and glucose levels.
  • Ongoing Support: Monthly check-ins (in-person or telehealth) to track progress and adjust your plan as needed.

This structured approach ensures care management services in Katy are effective and tailored to your evolving needs.

Why Choose Macie Medical for Chronic Care Management?

Macie Medical stands out as a trusted provider of chronic care management in Katy, Texas, for several reasons:
  • Expert Leadership: Led by Dr. Judith Aniekwena, double board-certified in internal medicine and obesity medicine, our best primary care physicians in Katy deliver specialized care.
  • Personalized Approach: We create customized care plans tailored to your unique health needs and goals.
  • Convenient Access: Located at 777 S Fry Rd Ste 206, Katy, TX 77450, we offer in-person and telehealth appointments for patients in Katy, Houston, and surrounding areas.
  • Advanced Technology: Partnerships with Withings and Freestyle Libre provide accurate, real-time health monitoring.
  • Compassionate Care: Our team prioritizes your comfort, offering counseling for chronic illness in Katy in a supportive, judgment-free environment.

Residents of Katy and Houston trust our primary care physician Katy, TX, team for comprehensive, patient-centered care.

What to Expect During Your Chronic Care Visit

Your chronic care management visit at Macie Medical includes:
  • Comprehensive Evaluation: A detailed review of your medical history, symptoms, and lifestyle by a primary care physician in Katy.
  • Customized Care Plan: Development of a personalized plan with achievable health goals and treatment strategies.
  • Ongoing Monitoring: Regular check-ins to track progress, adjust medications, and address new concerns.
  • Care Coordination: Collaboration with specialists to ensure seamless, integrated care.

Our care management services in Katy are designed to keep your treatment consistent and effective, helping you manage chronic conditions with confidence.

Start Your Chronic Care Journey with Macie Medical

Take the first step toward better health with our CCM in Katy, TX. Contact Macie Medical at +1 (713) 300-3905 to schedule your consultation or book an appointment today. Let us help you live a healthier life!

Macie Medical is proud to offer chronic care management services to residents of Katy, Cinco Ranch, Cypress, Richmond, Fulshear, West Houston and surrounding areas.

FAQs About Chronic Care Management in Katy, TX

What is included in chronic care management services?
Our CCM program includes a personalized care plan, medication management, regular follow-ups, and coordination with other healthcare providers.
Patients with two or more chronic conditions that are expected to last at least 12 months such as diabetes, hypertension, or asthma qualify for CCM services.
Monthly check-ins are a key part of the program, but additional visits may be scheduled based on your needs.

Chronic care management (CCM) is covered by medicare and government insurance programs for people with two or more chronic conditions
In addition, most commercial plans and affordable care plans also cover chronic care management.

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