Easter Seals relationship expanded to support commercial members with complex needs

Effective April 2, 2018, we integrated Community Health Navigators (utilized by Easter Seals) into our care management program to provide enhanced care transition for Anthem 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

Easter Seals does not replace Anthem Case Management, the care or the care management provided by PCPs and specialists. Instead, it provides an extra layer of support with Community Health Navigators 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. Easter Seals will make an initial outreach to identified members to determine the appropriate level of services; they will not provide any clinical services. 

 

An Easter Seals Community Health Navigator 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 Easter Seals and complex care services, please contact 800-231-8254.