Understanding Coordinated Care Management

Care management is a vital treatment application for individuals with chronic illness who require extensive treatment and preventive care. At Canopy Health, we’re extremely proud of our care managers and the work they’re doing to keep our members healthy, happy, and productive.

What Is Coordinated Care Management?

Modern healthcare organizations such as Canopy Health use coordinated care to reduce members’ out-of-pocket expenses, improve healthcare outcomes, and provide a positive patient experience. As a member, you benefit from physicians and care managers working together to identify your unique healthcare needs and potential roadblocks to care. Coordinated care is particularly beneficial for those who have chronic health conditions (like diabetes, dementia, or heart disease) as well as minority groups who struggle with access to care.

Coordinated care is also a response to shortcomings in the traditional, fee-for-service (FFS) model. In most FFS plans, providers are paid for their covered services, and there is very little oversight regarding the type or quality of care patients receive. Unfortunately, with minimal coordination and communication between providers, patients’ out-of-pocket expenses can skyrocket due to duplicate procedures, unnecessary tests, miscommunications, and other inefficiencies.

How Does Care Management Improve Our Members’ Health Outcomes?

As a Canopy Health member, you have access to our state-of-the-art alliance of Bay Area physicians, hospitals, and care centers. However, you don’t have to navigate them alone. Instead, your primary care physician (PCP) and care management team will help you build a plan and identify strategies that can help you avoid complications and improve your overall health.

With our innovative Alliance Referral Program, your PCP can refer you to any specialist throughout the Canopy Health alliance. Our alliance includes talented PCPs at Hill Physicians Medical Group, John Muir Physician NetworkMeritage Medical Network, and Santa Clara County IPA (SCCIPA).

Your physicians will use streamlined communication tools to share up-to-date information about your healthcare needs and treatment plan. Timely, accurate data management is essential to effective coordinated healthcare.

At the same time, our alliance’s experienced care managers identify at-risk members to coordinate their healthcare needs. Our dedicated care managers can personalize your healthcare and offer hands-on assistance. They can help:

  • Educate you about your chronic conditions
  • Empower you to make better healthcare decisions
  • Connect you with community resources that encourage a healthy lifestyle or support at-risk members
  • Set up reminders for your doctor appointments and prescription refills
  • Listen to your concerns about treatments or potential roadblocks to care
  • Direct you to physicians and providers who speak your native language, understand your cultural sensitivities, and honor diversity
  • Track your healthcare data and monitor your need for services and support

We use cutting-edge population health management strategies to improve our members’ experiences and outcomes. Canopy Health and its alliance carefully study members’ health data, track their outcomes and risk factors, and assess physicians’ performance.