Care Coordination

Right care, right time, right place.

Goal:

Enhance navigation, connections and the coordination of care across the delivery system.

Strategies:

• Connection to care
  • Increase the number of patients connected to medical, mental health and substance use disorder services via the Connect to Care Program
• Housing screening and connections
  • Improve housing navigation and flexible financial resources for homeless/at-risk patients and families via the Housing is Health Program
• Mobile health resources
  • Inform and support coordination of mobile health services to improve access and linkages to continuing care
• Health information exchange
  • Optimize HIE capabilities to improve access, create efficiencies, and enhance clinical decision-making and care coordination

A focus of the Partnership is to identify, prioritize and implement strategies to help low-income populations navigate the health care delivery system and help connect them to the ‘right care, at the right time, in the right place.’