Care Management

Care Management is essential to everything we do. Care Managers ensure the continuity of care that occurs between providers, hospital, and home by:

 • Helping patients and practices manage chronic diseases according to national evidence-based treatment guidelines

• Targeting care management services to help patients avoid unnecessary emergency room visits, hospitalizations, and readmissions

• Assisting patients with hospital transition to ensure medications, services, and equipment are in place and properly utilized

• Conducting medication reconciliation to ensure prescriptions are filled and no discrepancies exist

• Linking the patient back to the medical home after a hospital discharge

• Coordinating care with the medical home and other community agencies providing supportive services

To be eligible for care management, a patient must receive Carolina Access II Medicaid or be Dually Eligible (Medicare/Medicaid), and the patient's primary care physician must be a member of a participating medical practice.

Each network practice is assigned a care manager and provides the practices with:

• Ongoing education and training;

• Data analysis on utilization patterns and performance;

• Continuous quality improvement initiatives; and

• Centralized disease management program development efforts.