Health Systems
Our flexible approach to care management, coupled with our revolutionary technology platform, has enabled us to manage programs ranging from several hundred medically complex members to hundreds of thousands of medically diverse members.
CHS has provided services to state Medicaid agencies, hospitals, and universities. We have provided ancillary services to a number of commercial clients as well.
The Goals of CHS Programs
At CHS, we use care coordination activities to generate a patient-centric care plan, which ultimately guides the delivery of safe, appropriate, efficient, and effective care to our members. Our goal is to produce a patient-centric care plan of exceptional quality and high value to the patient, caregiver, care team, and the whole system of care with the following results:
Government Programs
Community Health Solutions is nationally recognized for our experience, leadership, and results, which enable us to provide innovative and comprehensive medical care management to a diverse client base.
With offices in Florida, Arkansas, South Carolina, and Illinois, CHS is experienced in developing and managing Medical Home Network programs for state Medicaid entities. CHS also has specialized programs for both dual eligibles and medically complex children and adults.
CHS provides
Our Medical Home Model
Dual Eligibles
CHS offers senior members enhanced benefits. Senior members receive all Medicare and Medicaid benefits.
Plus:
Medically Complex Children and Adults
In 1992, the American Academy of Pediatrics (AAP) published a landmark statement supporting the establishment of a family-centered “medical home” for all children. The conceptual model describes holistic care that is accessible, continuous, comprehensive, compassionate, coordinated, family centered, and culturally effective. CHS supports the AAP in the development of Medical Home Network programs, especially for the most vulnerable of our children. CHS believes that children, as well as adults, with medically complex conditions attain optimal health status when supported in their home and community environment.
We provide home visits by registered nurses who:
Collaborative Care Networks
The success of Collaborative Care Networks is critical to bringing comprehensive, coordinated, and integrated health care services to low income populations.
Section 10333 of the newly enacted health reform law authorizes the creation of Community-Based Collaborative Care Networks. CBCCNs, made up of safety-net hospitals, community health centers, and other safety-net providers, offer coordinated care for vulnerable patients in their areas – increasing health care access and quality.
CHS assists with program formation, administration, and operations including:
Contact us today at info@chsamerica.com or call 1-800-514-7621 for more information.
Case Management
The Scope of Our Care Management Program
The CHS Care Management Program incorporates the following activities to promote wellness, facilitate member care, and improve clinical and functional outcomes:
Our Care Management department is composed of the Chief Medical Officer, the Manager of Care Management Programs, registered nurse care coordinators, educators, 24-hour triage nurse, and care advocates.
The Six Care Initiatives
The CHS Care Management Program comprises six major initiatives designed to facilitate members’ receipt of necessary, appropriate, and quality care. These initiatives also assure members have access to MHN providers, along with effective and efficient utilization of services and resources. All department personnel serve as facilitators of necessary services for eligible members. They collaborate with the MHN providers to promote wellness through preventative services, education, coordination of services, and monitoring of ongoing care needs of the member.
Benefits for Insurance Companies, Third Party Administrators, and Self-Funded Groups
Your business is not only competitive but also complex, with many problems to solve. Like many other organizations, you’re probably focused on decreasing costs through improving administrative efficiency, integrated systems, and clinical outcomes. CHS is your SOLUTION! Once implemented, the benefits, both tangible and intangible, will increase your competitiveness and satisfy your clients.
The cost/benefits of case management are well documented. In today’s cost-conscious health care environment, case management must prove its economic value as well as its impact on clinical outcomes.
Care Management Benefits
Tangible benefits may include:
Intangible benefits may include:
To learn more or to request a quote please contact us at 1-800-514-7621, or email info@chsamerica.com.