Medicaid beneficiaries ages 50 and older and other individuals with Medicare or private insurance living in nine area counties can now access Lifespan’s comprehensive care management and healthcare coordination services.
We are partnering with Lifespan to expand access in Monroe, Livingston, Genesee, Wayne, Ontario, Steuben, Chemung, Seneca, and Yates counties. The goal is to improve health outcomes for individuals who have medical, behavioral health, and/or social needs by helping them coordinate their care and connect to supportive services.
As part of this collaboration, we are providing technical support to ensure the program meets its goals. This support includes consultation on data and analytics, and a program evaluation report.
Licensed Practical Nurse healthcare coordinators and social work care managers work in tandem with medical providers to coordinate care and help individuals navigate systems. They schedule and attend medical appointments with patients, coordinate transportation for appointments, conduct medication reconciliations at home, and provide health literacy training. Lifespan’s social workers visit people at home, assess needs, and link individuals and their families to supportive services.
These care management services are also part of a network of community-based care management agencies that work with individuals with serious and complex physical health, mental health, and substance use disorders to achieve better health outcomes and reduce costs. Greater Rochester Health Home Network (GRHHN) is a lead health home in this area, responsible for managing and supporting the network of care management agencies.