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Member Onboarding

SCCP believes that timely and effective outreach to a New Member is a key service that can positively affect a New Member’s understanding and future compliance. Therefore, our Onboarding of New Member Services is designed to provide Health Plans with High Touch, Multimodal New Member Engagement.

New Member Welcome Encounter (Via Face-to-Face or Telephone)

This first encounter is designed to start the process towards achieving high member satisfaction and retention rates by creating a positive first impression, establishing trust, addressing questions, and educating the New Member. The New Member Welcome Encounter includes:

Introduction and Welcome to the Health Plan
Verifying or Updating Demographic Information
Verifying New Member Receipt of Member ID Card, New Member Information Packet, Handbook, and other Welcoming Materials
Reviewing Member Handbook with the New Member
Discussing Member Benefits and Coverage Options
Confirming PCP Assignment
Completing Health Risk Screening
Setting Up the Heath Risk Assessment Appointment
Addressing New Member Questions and Concerns



Location of “Hard-to-Find” Members

Recognizing that locating New Members can present a challenge for Health Plans, SCCP offers a unique approach for engaging “hard to locate” populations that involves:

“Feet on the Street” Team – Care Coordination Navigators from Local Communities Leveraging Community Relationships
Partnerships with Community Stakeholders
Verifying New Member Receipt of Member ID Card, New Member Information Packet, Handbook, and other Welcoming Materials
Mobile Messaging – Use of Text Messaging as a Cost-effective Member Engagement Platform



Pre-Care Management Activities

As a part of New Member Onboarding, SCCP, through its Clinical Care Coordination Staff, engages in a variety of activities designed to jump-start the clinical care management process for New Members:

Conducting Health Risk Assessments
Completing Care Plans with Input from New Members
Getting New Members Attestation to Care Plan Participation
Working with New Members to Schedule PCP and Other Medical Appointments
Addressing Requests By New Members to Change PCP
Addressing Urgent Health/Social Service Needs of New Members
Hand-Off of Clinical Data and Relevant Health Information to Health Plan Clinical Care Managers
Appropriate Reporting

Member Care Coordination

• SCCP is uniquely positioned to provide comprehensive, person-centered, community-based care coordination services for high cost, high risk populations, including.

o Onboarding of New Members services designed to provide Health Plans with high touch, multimodal, new member engagement support

o Clinical care coordination/care management services

o Enhanced care coordination functionality through an advanced interoperable HIT platform

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CHILDREN AND YOUTH

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PREGNANT WOMAN

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FAMILIES

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SENIOR WITH DISABILITIES

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FORMER FOSTER CARE CHILDREN

Physician Extender Services for CMS Chronic Disease Management

SCCP works with physician groups (ACOs, PHOs, IPA, etc.) and independent physicians to provide beyond-the-office clinical care management support.


SCCP works with physician groups (ACOs, PHOs, IPA, etc.) and independent physicians to provide beyond-the-office clinical care management support.

Chronic-Disease Self-Management Support – SCCP enables physicians to improve their care delivery to clients with chronic illnesses by providing Centers for Medicare & Medicaid Services (CMS) reimbursable services to Medicare patients with two or more CMS eligible chronic conditions. Chronic Care Managers provide a minimum of twenty (20) minutes of telephonic care/case management support per month to each Medicare patient enrolled in the program.


Flagging Care Gaps/Real-Time Alerts Regarding Patient Health Status – SCCP’s Care Coordination Team supports the tracking of clinical outcomes (HEDIS, quality performance measures, etc.) and gaps in care. Alerts and gaps, which are automatically triggered by the HIT system, are responded to appropriately by the Care Coordination Team. Where necessary, the Care Coordination Team will assist patients in assuring the appropriate screening and/or assessment appointment is scheduled and attended by the patient.


Care Gap Plan – SCCP’s Care Coordination Team develops care gap plans to ensure provision of services missed by each patient, including, but not limited to, annual preventive exams, immunizations, women's healthcare screenings, and missed services for chronic health conditions, prenatal care, and behavioral health follow-up.


Discharge Planning and Transition of Care Support – For patients transitioning from inpatient to outpatient status, SCCP provides transition of care support.


Monitoring and Tracking of Health Status – SCCP’s Care Coordination Team supports the ongoing monitoring and tracking of the health status of patients through regular telephonic contact with assigned Patients.


Reporting – SCCP hands off patient clinical data and relevant health information to physician partners in a timely manner. SCCP provides reports physician partners based upon agreed upon reporting periods.



24 Hour Triage Service

SCCP can provide a triage call service for clients 24/7, holidays and weekends. The triage call service is staffed and managed by RNs utilizing evidence-based, industry standard triage protocols. The triage call service aligns with all applicable certifications and qualifications for triage call service staffing.



NEMT Logistics (Non-Emergency Medical Transportation)

• SCCP’s Population Health Management Value Proposition provides effective Care Coordination by making Non-Emergency Medical Transportation (NEMT) an integral part of our service offering. SCCP’s approach is that the Care Coordination team has stake in all aspects of care delivery for members they are responsible for managing including but not limited to transportation needs.


• The bottom-line is that SCCP’s holistic approach to Care Coordination ensures that high touch is not limited to just one critical component but addresses all aspects of Care Coordination required to ensure positive outcome for members regardless of health conditions.


• SCCP’s NEMT is a cooperative of NEMT providers with SCCP serving as the Management Company delivering Transportation Logistics, Dispatch Management and Technology driven high level of on-time scheduled as well as on demand transportation needs.