Case Management
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Case Management

Case management is a collaborative process which assesses, plans, implements, coordinates, monitors and evaluates the options and services to meet an individual’s complex health needs, using communication and available resources to promote quality, cost effective outcomes.

Criteria for eligibility includes:

  • Members with Cystic Fibrosis who have at least one emergency department visit or hospital admission in the past 6 months
  • Members with Multiple Sclerosis and who are experiencing major impairment and deterioration
  • Members with polypharmacy of 17 or more prescribed medications
  • Members experiencing severe physical trauma within the past 3 months who have had an inpatient length of stay greater than 6 days and for whom transitions in levels of care are anticipated
  • Members with Sickle Cell Disease who have had 2 or more hospital admissions in the past 12 months
  • Members with severe spinal cord injury within the past 3 months and who are experiencing major impairment • Other complex care situations will be considered

Services include:

  • Comprehensive assessments
  • Integrated goal and care planning
  • Care and resource coordination
  • Education about condition or disease, including self-management
  • Community linkage and resources

HEALTH MANAGEMENT

Health Management programs within CCHP are designed to improve the health of individuals with specific chronic conditions and to reduce health care service use and costs associated with avoidable complications, such as emergency room visits and hospitalizations.

Members with Major Depression over the age of 18, members with Asthma between the ages of 5-17 and members with Type 2 Diabetes over the age of 18 are provided an introductory letter explaining the program, including how to opt out if desired, as well as newsletter communications and preventative care reminders throughout the year.

 


Healthy Mom, Healthy Baby

Our Healthy Mom, Healthy Baby program helps pregnant women get the support and services they need to have a healthy pregnancy and baby. A member may receive services in her home or over the phone from social workers or nurses who are specially trained in maternal/infant health. This program also offers high-risk pregnancy services and breastfeeding support by Certified Lactation Consultants. 

For more information about the Healthy Mom, Healthy Baby program, call 877-227-1142, option 3.

We would be happy to come to your office to discuss our various programs and incentives for each Notification of Pregnancy form we receive. Please complete one of our Notification of Pregnancy forms below and fax it to 414-266-4726.

 

Make a referral for Case or Disease Management

Please complete one of our Referral forms below and fax it to 414-266-1715 or call 414-266-3173.


Read a story about how the Depression Disease Management program has helped one CCHP member.

Medicaid

Children's Community Health Plan

PO Box 56099
Madison, WI 53705
1-800-482-8010

Together with CCHP

Children's Community Health Plan

PO Box 1997, MS 6280
Milwaukee, WI 53201
1-844-201-4672

 

National Committee for Quality Assurance (NCQA) Accreditation

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