Off the Shelf TA

Care Coordination/Integration


Found 37 Results
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Health Policy Matters

Addressing Food Insufficiency for Individuals with Chronic Illness


Addressing Food Insufficiency for Individuals with Chronic Illness Health Policy Matters (HPM) has expert knowledge of Flexible Services for nutrition with a focus on both Medically Tailored Meals (MTM) for high risk members and other cost-effective options for ACO members at low or moderate risk. The goal of this project is to support effective and [...]

July 29, 2020


Health Policy Matters

Behavioral Health CP Transitions of Care


Behavioral Health CP Transitions of Care Health Policy Matters (HPM) has experience developing best practice approaches to address Transitions of Care for Behavioral Health CPs and ACOs. HPM would provide whatever level of customization the ACO or CP desires, and will give attention to existing processes in both the ACO and the CP organization, in [...]


SMC Partners Logo

Collaborative Care Management Integration


Collaborative Care Management Integration SMC Partners offers program and process design, data management and systems integration services to enable ACOs and Community Partners to connect their systems and create a community-wide view of care management performance metrics. Today many ACOs and CPs rely on faxes and manually maintained spreadsheets to record events such as care [...]


Collaborative Healthcare Strategies

ED Care Alerts Improve Performance


ED Care Alerts Improve Performance Almost all ACOs and CPs have access to ADT alerts. Almost all hospitals in Massachusetts have access to a state-wide high-risk patient alert system. These are the exactly right tools for the job of improving engagement, follow up after discharge, and reducing readmissions! This TA engagement will help your team: [...]


Day Health Strategies

Get It Done: Meeting DSRIP or Flexible Services Deadlines (Larger Scale)


Get It Done: Meeting DSRIP or Flexible Services Deadlines (Larger Scale) Do you need help managing upcoming submissions, such as Quarterly Tracking Reports (QTR), Budgets or Budget Narratives, Progress Reports or Participation Plan Updates? No matter the size or current stage of completion, we can help you get your deliverable submission over the finish line. [...]


Day Health Strategies

Get It Done: Meeting DSRIP or Flexible Services Deadlines (Smaller Scale)


Get It Done: Meeting DSRIP or Flexible Services Deadlines (Smaller Scale) Do you need help managing upcoming submissions, such as Quarterly Tracking Reports (QTR), Budgets or Budget Narratives, Progress Reports or Participation Plan Updates? No matter the size or current stage of completion, we can help you get your deliverable submission over the finish line. [...]


Stroudwater

Improving Primary Care Chronic Opioid Management


Improving Primary Care Chronic Opioid Management 36% of opioid deaths involve a prescription opioid. (CMS Roadmap: Fighting the Opioid Crisis; November 2019). The Six Building Blocks Program was developed by a physician-led team from the University of Washington and the Kaiser Permanente of Washington Research Institute to improve management of chronic pain and chronic opioid [...]


Healthcentric Advisors

Incorporating Remote Care Management Solutions


Incorporating Remote Care Management Solutions Healthcentric Advisors can help practices support patients remotely through the continuum of care management by creating an actionable framework around disparate patient information. Our technical assistance helps providers receive reliable, between-visit information and supports the prioritization of their data for more efficient, targeted communications or care changes, in real-time vs. [...]


Advocates for Human Potential, Inc.

Integrating Behavioral Health and Primary Care 2 Day In-Person or Virtual Classroom Intensive Training


Integrating Behavioral Health and Primary Care 2 Day In-Person or Virtual Classroom Intensive Training Time: 2 full days, intensive course. Audience: Primary care and behavioral health teams at ACOs and CPs. Location: In person, interactive online learning, or blended learning. Goal: Effective integration of primary care and behavioral health is essential to achieving better health [...]

July 28, 2020


Advocates for Human Potential, Inc.

Integrating Behavioral Health and Primary Care Virtual Classroom Introductory Training


Integrating Behavioral Health and Primary Care Virtual Classroom Introductory Training Time: 2-day introductory course. Audience: Primary care and behavioral health teams at ACOs and CPs. Location: Interactive online learning. Goal: Effective integration of primary care and behavioral health is essential to achieving better health outcomes. Primary care and behavioral health providers all play an important [...]


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