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Care Management
Partnering to advance care management empowers health system leaders to deliver coordinated, patient-centered care that drives better outcomes, lowers costs, and ensures long-term sustainability.
Led by regulated professionals, care management bridges hospital, home, and community care to meet each patient’s unique medical and social needs.
- Whole-person care: We assess not just medical needs, but also functional and social determinants of health.
- Dynamic care planning: Our plans evolve with the patient, ensuring responsiveness to changing needs.
- Expert navigation and advocacy: We guide patients through the health system, reducing confusion and delays.
- Seamless coordination: We connect interdisciplinary providers across sectors for integrated care delivery.
- Empowered patients: Through education and engagement, we build self-management capacity and resilience.
- Continuous improvement: Ongoing monitoring ensures quality and accountability.
The Impact For Hospitals:
- Fewer re-admissions and emergency visits
- Reduced ALC (Alternate Level of Care) days
- Improved discharge flow and resource optimization
- Higher patient and caregiver satisfaction
Together, we advance the Quintuple Aim – driving better health outcomes, equity, experience, and sustainable care delivery.
Strategic Partnerships for Whole-Person Care
We unite health systems, community organizations, and payers to address both clinical and social needs.
Data-Driven Population Health with interRAI
InterRAI-HC tools to deliver personalized, evidence-based care. These assessments guide dynamic care plans, identify risks, and track outcomes.
Health Home Model for Seamless Access
Our Health Home-inspired model offers a single, streamlined access point to integrated care. This “one door” approach simplifies navigation, strengthens communication, and improves transitions.