At CPCMG, our Population Health team works behind the scenes to support your family and your provider in delivering higher-quality, more comprehensive, and more efficient care. Although you won’t see this team in your CPCMG office, they play a vital role as part of the care team alongside your provider.

Our team of pediatric registered nurses (RNs) brings a wide range of experience, including emergency medicine, critical care, infusion therapy, hospital care, and triage services. They currently manage the majority of messages sent through MyChart—up to 25,000 per month—providing education, guidance, helpful resources, and timely responses. When needed, they can quickly connect with your CPCMG provider or office to escalate urgent concerns or coordinate appointments.

This year, our RNs also began handling medication refill requests from both patients and pharmacies. In the months ahead, they’ll play a larger role in coordinating care for specific needs such as newborns, asthma, mental and behavioral health, and more.

Thanks to our new phone system, RNs can now follow up directly with families after appointments, medication changes, or emergency visits, as directed by your child’s provider. Each RN has their own phone extension, voicemail, and a dedicated phone number to ensure smoother communication.

Our Population Health Care Coordinators (PHCCs) are also a vital part of our care team. Many families need non-clinical support—whether it’s connecting with community resources, navigating the healthcare system, or managing the everyday challenges of caring for a child with complex needs. Sometimes, it’s the foundational support that makes all the difference.

When your CPCMG provider submits a referral to our Population Health team, our PHCCs are alerted that you may need assistance in a specific area. This support can include helping you find essentials like food or diapers, locating a therapist for your teen, arranging transportation to a specialist, or connecting you with autism-related services for your child.

Several important value-added programs are part of our Population Health team. This includes Lactation Services, Behavioral and Mental Health, our W.E.L.L. (nutrition) program, Adolescent Care, and the newborn experience. Our goal is to ensure these services are interconnected and closely coordinated with our PHCCs and RNs, so your child receives the most comprehensive and seamless care possible throughout their journey with CPCMG.

No matter the region, office, or CPCMG provider, our Population Health team is always a key part of your care team.