The CDPHP Care Team consists of Medical Directors, Pharmacists, Inpatient Care Coordinators, Medical and Behavioral Health Case Managers, and Healthcare Advocates. The plan deployed the multi-faceted team within the hospital to make sure members’ needs are met, and ensure the health plan is part of the hospital utilization solution, and not a barrier.
The CDPHP Care Team visits with each member upon admission to introduce themselves, their role, and how to get in touch with the team while hospitalized. The team then completes an assessment of what brought the member to the hospital. The assessment includes evaluating the member’s relationship with a primary care physician, history of chronic conditions, compliance with an established plan of care, support systems, and any social determinants of health that may be impacting their health (i.e. lack of transportation, access to healthy food).
CDPHP Medical Directors round with our staff three days per week to evaluate the needs of the most complex members. Authorization decisions can be made on the spot, education of CDPHP programs to support the members’ health care needs are introduced, and assistance in breaking down any barriers to the next step in care takes place. Through daily interaction with members, CDPHP serves to support the hospital’s treating physician by reinforcing health care education, identifying gaps in care that can be addressed while at the hospital or upon discharge, and getting people engaged with the many supportive programs CDPHP offers free of charge.