Welbyhealth

Welby Health (welbyhealth.org) operates what it calls a clinical operating layer for physician practices, medical groups, health systems and ACOs. The company supplies licensed registered nurses and nurse practitioners plus supporting systems to manage patients between office visits, with the stated aim of addressing readmissions and quality-measure performance. Client practices retain ownership of the patient relationship; Welby's clinicians work under the client's name and inside the client's existing electronic medical record rather than through a separate vendor portal.

The delivery model centers on chronic care management (CCM), advanced primary care management (APCM) and remote patient monitoring (RPM). Patients referred by the practice are scored against a universal acuity framework spanning low, moderate and high acuity tiers, which determines the program mix and monthly care time (roughly 15-30 minutes per month at low acuity, 40-60 minutes at moderate acuity, and 60+ minutes with intensive RN involvement at high acuity). Acuity scoring inputs include vitals versus goal, number of chronic conditions, hospitalizations in the prior 12 months, and medication complexity. Welby clinicians review patient data daily, initiate outreach when values change, and document each touch back into the client's chart with timestamped audit trails, escalating to the practice's physicians only when clinical oversight is required. Care is delivered according to internally defined, evidence-based "Welby Care Pathways," mapped to each client's protocols and EMR configuration, with athenahealth and eClinicalWorks cited as supported systems.