In 2017, two pilots were conducted by Consistent Care Services (CCS). The first pilot, Summit, was started in January 2017 and targeted patients in the Spokane area with high historical claims. The goal being to reduce overall spend for each patient. The Summit program provides care coordination for people who need help navigating the health care system. This program targets individuals needing assistance with direction to the appropriate level of care, access to community resources and are in need of advocacy. Our team performs a holistic assessment of the patient. We are then able to identify areas where the patient may be facing barriers to better health care access, are in need of education, or need assistance connecting to resources. With this approach, we are able to reduce overall spends of the patient and get them health care access to meet their individual needs.
The second pilot, TReS (Treatment and Recovery Support), was started in August 2017 with seven patients who were referred to Consistent Care Services from Amerigroup of Washington. These patients were in the hospital needing IV antibiotics for infections related to substance use disorders (SUD). The goal of this pilot was to transition the patient to another venue, one that could administer the IV antibiotics while CCS encouraged the patient to seek chemical dependency treatment. This pilot has also had initial success. The Treatment Recovery Education and Support (TRES) is an intensive case management program that works one on one with individuals suffering from severe substance abuse that have now acquired medical complications as a direct result. This demographic generally has severe social determinants as well as mild to severe medical complexities. Our Nurse Case Manager and Client Advocate initially meet our patients in the hospital and perform an initial assessment and establish mutual agreed upon goals. Depending on the severity of the medical complexity, the patient may need to transition to a lower level of care all while still receiving our services. Initially this may include going from the hospital setting to an acute rehabilitation setting then to residential substance abuse treatment. Our team closely follows the patient from one avenue to the next eliminating barriers and providing care coordination, all while meeting the patient’s goals to recovery.