Health Home Care Management

A Health Home is a care management service model whereby all of an individual’s caregivers communicate with one another so that all of a patient’s needs are addressed in a comprehensive manner. This is done primarily through a Care Manager who oversees and provides access to all of the services an individual needs to assure that they receive everything necessary to stay healthy, out of the emergency room and out of the hospital.

Health records are shared (either electronically or paper) among providers so that services are not duplicated or neglected. The Health Home services are provided through a network of organizations – providers, health plans, and community-based organizations. When all the services are considered collectively they become a virtual “Health Home.”

Individuals work with a primary Care Manager to discuss their needs and create their own Plan of Care. This Plan of Care is designed by the client and for the client, and will include other service providers, and supports in their life. The individual will have responsibilities in the Plan, as will others, to help them accomplish their goals and meet their needs. The Care Manager will, with permission, collaborate with other agencies and service providers to help meet the individual needs and coordinate services.

Common Goal Areas: