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Chronic Care
Management

If you or a loved one has at least two or more chronic conditions expected to last 12 or more months and you are a medicare beneficiary, you are eligible for Chronic Care Management services (CCM). At Healthcare Connect, we help provide you with a comprehensive care plan which includes:

  • Health Problems
  • Medications
  • Health Information
  • Other Healthcare Providers
  • Goals
  • Community Services

Additionally, CCM specifies what care the patient needs and how their care will be managed and coordinated as well as self-management and decision support. CCM is generally non face-to-face but is a critical primary care service that contributes to the bettering of the overall health, wellness, and care for each patient. 

Transitional Care Managment

Healthcare Connect is also a provider for Transitional Care Management (TCM). In the 30 days following discharge from acute care such as a hospitalization or inpatient facility, Healthcare Connect helps provide vital additional care as a patient moves from one setting to another. This includes:

  • Ensuring Medication management and treatments
  • Scheduling follow-up visits with providers and specialists
  • Educating Patient and/or caregiver about your condition

While the scope of TCM is broad and includes temporary services, Healthcare Connect supports patients post-discharge, prevents/detects medical errors and reduces the need for readmission.