Traditional U.S. models of health care that separate the mind and body have a negative impact on health care access, cost, and quality of care. HNE believes that Care Management must be provided in a fully integrated and collaborative model. The Care Managers at HNE are trained in the Integrated Case Management methods and tools developed by the Case Management Society of America.

The Care Manager, whether a Registered Nurse or Behavioral Health Specialist, addresses educational opportunities, physical needs, psychological needs, psychosocial risks, and protective factors. This relationship with a single Integrated Care Manager results in minimal handoffs between providers.

Fewer handoffs mean:

• More consistent experience for patients, caregivers, and providers
• More personalized understanding of patients’ needs
• Development of a trusting relationship between Care Manager and patient

Our Care Managers work with members and their providers to develop a plan to promote self-management of risks and conditions. Through regular telephone contact, our Care Managers support members by helping them to reach their goals and achieve optimal outcomes.

What is Clinical Services Integration? 

At Health New England, our Clinical Services Integration (CSI) program brings together:

• Health Promotion
• Integrated Care Management (Behavioral Health, Care, and Disease Management)
• Pharmacy Services 

CSI supports providers and helps members navigate the complex health care delivery system. Members are identified for participation through health data algorithms, Health Needs Assessments, and nationally recognized case management screening tools. We also welcome referrals from utilization management nurses, other health care providers, and the member or family.