The Medical Homes Network Program

jessievenegas Jessie Venegas — 12/01/2009

Foresight Links Corporation

The Medical Homes Network Program in South Carolina connects each beneficiary with a primary care physician who is part of a network managed by a Care Coordination Services Organization (CSO). CSOs provide disease management, care coordination, and data management services to help physicians function as medical homes. The CSOs also have a direct link with beneficiaries, providing consumer education on missed primary care appointments and appropriate emergency room utilization and engaging beneficiaries in the care management process. Through the emergency room “high flier” program, CSOs contact beneficiaries who have visited the emergency room more than twice in the previous three months, offering education about effective primary care use and linkages to additional services to help avoid future emergency room visits. CSOs also provide high flier information to primary are physicians. South Carolina reports that the program has been a leading factor in the approximate nine percent reduction in the number of emergency department claims for the state’s Medicaid population from 2003 to 2006.

Fragility, pluripathology/polipathology and/or complex chronic diseases

Goals Detection:
Promotes early intervention through primary health care measures , Provides registries and patients contact systems , Shows new evidence on the importance of early detection, including guidelines of effective practices , Advances public education on the importance of early detection
Goals Treatment:
Develop basic elements for an integrated health system , Provides support health policies to facilitate the planning and integration at locally and regionally , Strengthens cooperative local groups to provide integral services , Improving access to health services across the entire spectrum, from prevention to treatment , Ensures the best quality of health services , It facilitates the management by processes , Emphasizes the care of pluri-pathological and fragile patients
Goals self-management:
Refocuses the health system to support self-management , Promotes patient involvement in planning services , Improving support services with an emphasis on peer support, the disabled and carers , Allows remote support to patients and their carers from health professionals

None

Progress

UNITED STATES OF AMERICA

South Carolina

South Carolina

Columbia

132 Westpark Blvd Columbia, South Carolina 29210
Practices Map

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