ForFor Managed Care Organizations
PA HealthCORE works with Managed Care Organizations (MCOs) to manage key disability services and support for people with disabilities and age related lesser abilities.
The status of a participant’s health and wellness is maintained by direct care workers and the participant’s changing needs are assessed by service coordinators. These support services also enhance social capital and create desired outcomes by reducing unnecessary emergency room visits, hospitalizations, and institutionalizations.
The PA Commonwealth is moving toward a managed services and support system and away from the standard waiver system. This managed care initiative is called Community HealthChoices. The initiative seeks to improve access to services, dramatically re-balance services towards home and community-based services (HCBS), contain uncontrollable costs, and improve the quality of care. In order to accomplish these goals, PA HealthCORE was formed to work with MCOs to manage those services on a statewide basis and offer member choice.
Under the old HCBS system of ‘any willing provider,’ there has been a patchwork of approximately 1,300 home care providers of varying capacity, experience, and quality. Participants were shown a randomized list of these providers, leading to uninformed decisions on whom shall provide the very services that enable their independence, rather than basing the decision on the quality of service. We believe that participants deserve better.
PA HealthCORE provides measurable outcomes, we’ve developed quality standards and metrics to make a meaningful difference in the lives of the people receiving those services. PA HealthCORE is committed to working with MCOs to design a better system that offers additional and alternative services and innovative solutions beyond the current waiver system. Our goal is to help create a delivery system that is efficient and both clinically and cost effective.
Contact UsPA HealthCORE understands the importance of measuring quality outcomes
WhatWhat you can Expect from us
PA HealthCORE partners with Managed Care Organizations (MCOs) to provide the best possible outcomes for participants. We monitor our outcomes to provide MCOs with the quantifiable data needed to maintain the strong relationship with participants and offer high quality care. We cover the full state of Pennsylvania, with a provider in every county, making our services readily and easily available.
Our shared functions model for Managed Care Coordination includes:
- Person centered planning for adults with physical disabilities and seniors
- Maintain in-person, local relationships with member, including home visits as indicated per person-centered plan
- Make home visits as the key to assess living daily routines, support systems, living environment, resource access and barriers to success
- Has in-depth knowledge of local geography, culture and languages
- Participants will say and report anything over the phone. Thorough assessment is needed in person, so a meaningful Individual Support Plan (ISP) can be developed and impactful
- Captures and reviews outcome data on specific services
When you work with PA HealthCORE, you have a partner that works with you.
ContactContact PA HealthCORE
Ready to find out how you can partner with PA HealthCORE? Contact us for questions, concerns, or to learn more about PA HealthCORE.
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