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Enhanced care coordination

Holistic approach to care

Care coordination is defined as deliberately organizing patient care activities and distributing that information across all of the participants concerned with a patient’s wellbeing to achieve safer and more effective care.

MCOs have the tools and resources to connect members with a broader range of services to meet individual needs. MCO care coordinators leverage real-time data analysis to develop a comprehensive picture of members and inform holistic care plans.

Social determinants of health

MCOs prioritize all aspects of health

MCOs are embedded within their communities. MCOs know the local organizations and the specific healthcare and social challenges community members face.

MCO care coordinators go above and beyond to ask the additional questions to ensure all factors of health are addressed. From previous health complications to safe living conditions, all aspects of health are top priorities for managed care coordinators.

Nearly 7 in 10 CBOs believe that healthcare is defined by factors, like housing and nutrition, that are beyond the clinical setting.

More than just physical health

Care coordinators work with beneficiaries to address the aspects of life that can have profound impacts to health. Read below for examples of how care coordinators have helped beneficiaries.

Addressing economic strains:

A beneficiary with significant medical issues was being evicted as a result of economic strains from the COVID-19 pandemic. Their managed care coordinator was able to assist the member in extending the eviction notice, applying for a COVID relief grant, and securing a grant cover $34,000 of back-rent.

Addressing access to care:

A beneficiary living in a homeless shelter, with no access to a phone or internet, got Medicaid coverage through expansion. His care coordinators found that he did not have a phone, and as a result could not contact his doctor to get the medication he needed. The care coordinators helped secure a phone, dispatch a Community Health Worker to help set up the phone and teach him how to use it, and assisted with getting him care.