Community Case Management
Coordinating long-term care services for medically complex children can be a daunting challenge for both parents and the state agencies responsible for their care. Often multiple agencies are providing a range of individual services, with no single point of entry for parents. Commonwealth Medicine’s Community Case Management program was developed to help public agencies deliver these critical services to vulnerable populations, while trying to alleviate some of the parents’ burden.
Community Case Management provides states and families with a single entry point to coordinate medically necessary, community long-term care services—from home nursing care to medical equipment. Our nurse case managers work directly with families to ensure the highest quality, most comprehensive care for their children. By streamlining services and openly collaborating with all relevant agencies, we are able to develop service plans unique to each child and family.
With expertise in third-party liability issues, we are also able to help states identify opportunities for private insurance to assume some of the financial burden for eligible members. The result is improved care for the state’s most clinically ill, medically complex children, while reducing the financial cost to its budget.
Community Case Management is the lead program at Commonwealth Medicine to manage the care of a population at risk for nursing facility placement. It is part of a larger effort that includes other Commonwealth Medicine services such as disability evaluation services, nursing home transition assistance when needed and clinical pharmacy utilization reviews of member drug therapies. We also utilize Commonwealth Medicine research and evaluation resources for valuable program evaluation consultation.