BCBSGa Community Care Coordination expands relationship with Preferred Community Health Partners to support commercial members with complex needs

Effective November 12, 2018, BCBSGa will integrate Community Health Workers utilized by Preferred Community Health Partners (PCHP) into our current care management program to provide enhanced care transition for BCBSGa members with complex needs.  Members will include, but are not limited to, those with the following:

• Hospital readmissions
• Frequent ER visits
• No engagement with PCP within three months or more
• Readmission risk score >24
• Multiple diagnoses
• Identified social determinants of health

 

PCHP does not replace BCBSGa Case Management, the care or the care management provided by PCPs and specialists. Instead 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.

 

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 that have been identified for complex care services.

 

For questions regarding PCHP and complex care services, please contact 800-353-0923.