Preferred Community Health Partners care management integration
Effective January 9, 2019, Anthem Blue Cross (Anthem) will integrate community health workers utilized by Preferred Community Health Partners (PCHP) into our current care management program to provide enhanced care transition for Anthem members with complex needs. Members will include but are not limited to those who have:
- Hospital readmissions.
- Frequent ER visits.
- No engagement with a PCP within three months or more.
- A readmission risk score greater than 24.
- Multiple diagnoses.
- Identified social determinants of health.
PCHP does not replace the Case Management department, nor the care or the care management provided by PCPs and specialists for Anthem members. Instead, PCHP provides an extra layer of support with community health workers as an extension of care management to help our members navigate the complex health care system.
Services are meant to complement members’ efforts to improve health outcomes. Identified members will be contacted to determine the appropriate level of services. PCHP will not provide any clinical services.
A PCHP community health worker may reach out to your practice to introduce themselves and establish a relationship with the physician. They may also discuss developing a mechanism by which to share information regarding patients who have been identified for complex care services.
For questions regarding PCHP and complex care services, please contact 1-888-334-0870.
January 2019 Anthem Blue Cross Provider Newsletter - California