Care Coordination
CHS’ model for care coordination fosters productive interactions between informed members (who take an active part in their care) and providers with resources and expertise. The ultimate outcome is that healthier and more satisfied members lead to more satisfied providers and appreciable cost savings.
Excelling Care Coordination
CHS provides a comprehensive, holistic approach to care coordination and employs a multidisciplinary team in the provision of care.
CHS’ model for care coordination fosters productive interactions between informed members (who take an active part in their care) and providers with resources and expertise. The ultimate outcome is that healthier and more satisfied members lead to more satisfied providers and appreciable cost savings.
RN
Care coordinator for children with primary medical diagnosis
Assessment
Care plan development
Facilitates and participates in care team meetings at MH as appropriate
Home visits as indicated
Education as indicated
Social Worker
Care coordinator for children with primary mental health or developmental diagnosis
Psychosocial assessment
Care plan development
Facilitates and participates in care team meetings at MH as appropriate
Links family to community-based resources as indicated
Education as indicated
Resource Navigators
Follows up with and advocates for families to address any barriers to medication adherence, specialty care
Gathers school and clinical information
Assists in scheduling/verifying appointments and transportation
Calls family to remind them of upcoming appointments or need to set up appointment for preventive care or equipment maintenance
Member Engagement Unit
Initial introduction from the new health plan to the member
Educates on general plan information
Establishes member experiences
Responds to member questions
Completes initial health risk screening
Assigns the member to a care coordinator depending on outcome of initial health risk screening