Reduce and avoid readmissions for Hennepin Health members admitted to Hennepin Healthcare (HCMC) secondary to substance use disorder complications and engage members earlier in Care Management. The goal is to reduce or avoid readmissions and connect to Substance Use Disorder treatment or support (harm reduction).
Inpatient to Community Care Management for Individuals with Substance Use Disorder
Project Goals
Project Description
All Hennepin Health members identified as experiencing a complication secondary to a substance use disorder and admitted to certain inpatient hospital care units are offered (while inpatient) are offered Care Management by a Hennepin Health delegate Care Management organization. Care Management and associated member develop a person-centered strengths-based care plan following discharge to the community.
Entities Involved
Medica, ActiveHealth Disease Management.
How Health Plans Support the Project
Hennepin Health, Hennepin Healthcare Systems, Hennepin County Human Services and Public Health, AVIVO.