Our innovative care management strategy centers on the primary care component of health care. It is critical that primary care providers are connected seamlessly with all network providers, each with access to the tools, tactics and resources they need to provide the right care, at the right time, in the right setting. This technological connection allows providers to make well-informed clinical decisions.
We touch every aspect of our patients’ health by maximizing their experience with providers at all levels of care, and focusing attention on optimizing health, versus illness and disease.
Our strategy has three primary components:
Multidisciplined Team: Our multidisciplinary team members engage, educate and assist the patients we serve using population health management strategies. Team experts include:
- RN Health Coaches
- Care Coordination Social Workers
- Population Health Assistants
- Physical Therapists
- Occupational Therapists
- Other specialists
Population Health Management: Our proactive application of strategies and interventions to defined groups of individuals across the continuum improves the health of those individuals at the lowest necessary cost.
- Improve Access to Care
- Coordinate Patient Transfers
- Manage 90-Day Episodes of Care
- Reduce Hospital Readmissions
- Initiate Prevention and Screenings
A Focus on Kentucky: An important part of our population health management strategy focuses on those health issues most critical to Kentuckians. Several needs prevail in the state of Kentucky:
- Preventive Screenings
- Cardiovascular Diseases
- Medication Compliance & Physician Visits
Contract Types Offered
- Pay-for-Performance (P4P)
- Episodes of Care (90-day episodes)
- Disease Management
- Total Medical Spend (up- and down-side risk models)
- Hospital Efficiency
Care Management Process
Here’s How to Join
To join, simply call 844.804.8725 or complete the online form. A CHI Saint Joseph Health Partners representative will contact you soon.