Care Coordination

Right care, right time, right place.

Goal:

Strengthen the health care delivery system through improved coordination, navigation and continuity of care to improve patient outcomes and system efficiency

Strategies:

• Connection to Health Care
  • Increase the number of patients connected to medical, mental health and substance use disorder services via the Connect to Care Program
  • Assess Connect to Care Program platform improvements, through Epic solutions or other, to improve referral tracking, reporting, bi-directional communication and care transitions for people with complex needs
• Housing screening and connections
  • Improve housing navigation and flexible financial resources for homeless/at-risk patients and families via the Housing is Health Program

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.’