Avoidable hospitalizations
Innovations
A rapid response team defuses crisis situations for children with complex behavioral needs.
Patients with chronic illnesses communicate with and receive real-time feedback from providers on at least a daily basis using customized mobile phone software, leading to better adherence, increased peak flow assessments, and fewer emergency department visits and missed school days.
The Sutter Care Coordination Program combines chronic care and disease management to address the medical and psychosocial needs of individuals with multiple chronic conditions.
CarePartners, a donated care program, matches uninsured Maine residents with primary care physicians who are willing to care for up to 10 patients for free. Case managers help enrollees obtain needed services, including hospital care, specialist services, and free or low-cost drugs through prescription assistance programs.
Essentia Health Heart and Vascular Center created a heart failure program combining chronic care and disease management principles to improve outcomes and reduce costs associated with heart failure care.
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