Chronic Care Management in Michigan is available to Medicare patients with 2 or more chronic conditions, and over 4 million people in Michigan have a lower quality of life because of chronic disease (1). With over 44,717 physicians licensed in Michigan, Chronic Care Management represents a significant opportunity to impact the lives of chronically ill seniors in MI (2) . Considering at least 62,000 Michigan residents die of chronic disease each year having a leading provider of Chronic Care Management such as CareHarmony for the communities of Michigan is a critical step in overall population health management (1). Participation in CCM in MI provides improves overall clinical outcomes for Michigan patients through 24/7 support, utilization of local Michigan resources, and high-levels of trust.
Care Coordinators provide their Michigan patients with 24/7 telephonic access for any assistance needs or concerns. Wayne, Genesee, and Kent county CCM patients, as well as other surrounding counties, in Michigan can communicate directly with coordinators for specific concerns. CCM recipients in Michigan are educated regarding their chronic conditions in between primary doctor’s visits and specialty appointments. Chronic Care Management in Michigan allows patients to stay up to date with preventative health screenings and immunizations as CCM coordinators provide scheduling assistance. Michigan patients participating in Chronic Care Management are given the opportunity to present and receive answers for any questions regarding provider instructions (e.g., medication usage, lifestyle modification) in between their appointments from anywhere in Michigan (e.g., Lansing, Ann Arbor, Flint) any day of the week. This 24/7 coverage gives Michigan CCM patients the confidence that their complete care is coordinated through CareHarmony’s Chronic Care Management program.
For many MI patients, coordinators are the means to many resources, both clinical and social. After assessing Michigan patients for barriers to care, Chronic Care Management team members make a care plan for addressing clinical and social barriers. Care coordinators specialize in pinpointing assistance accessible in Michigan for Chronic Care Management enrollees. Patients can be directed to Michigan Department of Health and Human Services to help relieve financial strain. Patients can be assisted with applications for SNAP benefits and the Michigan Choice Waiver Program through their Michigan Chronic Care Management program. Locations and schedules for sites supplying supplements from Food Bank of Eastern Michigan in Flint, and other cities in MI, can be relayed to the patient during CCM care.
Care coordinators that communicate with Michigan Chronic Care Management patients build trusting relationships. CCM coordinators make it a priority to familiarize themselves with local resources in Michigan. Primary and specialty providers of CCM patients in Michigan communicate routinely with their patients’ CCM coordinators. Caring CareHarmony CCM coordinators understand the diverse Michigan patient population and can relate to the culture in Michigan. Patients who have an established level of trust with their CCM coordinators are more likely to divulge barriers to care and ultimately benefit more from Chronic Care Management in Michigan. Chronic Care Management recipients in Michigan engage openly in dialogue with coordinators regarding wellbeing, financial pressures, or emotional status. CCM patients in Michigan have trusted their compassionate coordinators to locate resources both in and outside of Michigan and assist with completion of applications (e.g., for home services, for assistive devices). For example, CCM coordinators have assisted retirees from General Motors in Michigan with maintaining their independence and applying for eligible expense cutting programs through Chronic Care Management. Patients consenting to CCM services in Michigan receive requested information, confirmed responses, and guided care specific to their personal goals. The Michigan community should see positive improvement in overall population health from Chronic Care Management in Michigan as a result of trusted, open dialogue amongst providers, patients, and caregivers supported by CareHarmony.