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- Integrated Case Management
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As medical practice becomes more complex and demanding, coordinating care between various providers involved in a patient’s care is a challenge. It is not unusual to hear from patients, "my providers don’t seem to talk to each other". Many PCPs tell us that they are unaware their patient received services from a specialist. Here are some simple steps that you can use to improve communication between primary care physicians and specialists:
Molina Healthcare provides a comprehensive Case Management program to all health plan members who meet the criteria for services. The Case Management program focuses on coordinating the health care, services and resources needed by health plan members with complex needs and health care issues through a continuum of care. The Case Management program is individualized to accommodate and address the unique needs of each health plan member in collaboration with the member’s primary care physician and other physicians and health care professionals.
Examples of health issues that may qualify members for case management include:
Molina Healthcare’s Complex Case Management program offers you and your patients the opportunity to participate. Patients who are the most appropriate for this program are members who have the most complex service and health care needs. These members may include individuals with: multiple medical conditions, high level of dependence, conditions that require health care from multiple specialists and/or who have additional social, psychosocial, psychological and emotional issues that exacerbate the condition, treatment and/or discharge plan.
The goals of the Complex Case Management Program are to:
Molina Healthcare clinical staff including case managers and social workers and other non-clinical staff like community connectors work together with physicians and other health care professionals and the community to facilitate effective and efficient transitions of care. Our health plan members access health care and services across a variety of care settings and their overall health and well-being depends how effective we all can be together to navigate the health care system.
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