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Promoting Good Care and Communication

Date: 04/24/18

When you have a patient with multiple conditions or who needs complex, coordinated care, communication is key.

California Health & Wellness offers care management to help members who may not be able to facilitate care on their own. It’s intended for members with high-risk, complex or catastrophic conditions, such as asthma, diabetes, sickle cell disease, HIV/AIDS and congestive heart failure.

Care managers are trained nurses and other clinicians who act as advocates, coordinators, organizers and communicators. They support both patients and their caregivers, as well as you and your staff, and promote quality, cost-effective outcomes.

A care manager connects the California Health & Wellness member with the healthcare team by providing a communication link between the member, his or her primary care physician, the member’s family and other healthcare providers, such as physical therapists and specialty physicians.

Care managers do not provide hands-on care, diagnose conditions or prescribe medication. Instead, care managers help members understand the benefits of following a treatment plan outlined by a physician and the consequences of not following the plan.

Care managers can help your team with members who are not adhering to their treatment plan, members with new diagnoses and members with complex multiple comorbidities.

Providers can directly refer members to our care management program by phone or through the provider portal. Providers may call 1-877-658-0305 for additional information about the care management services California Health & Wellness offers.