- A systematic, evidence-based approach for early identification of eligible patients
- Needs assessment, development and implementation of an individualized care plan that includes patient/family education and actively links the patient to providers and support services, as well as outcomes monitoring.
Envolve recommends a multidisciplinary integrated care model consisting of a team who supports and complements the PCP, specialist medical providers and behavioral health providers by:
- Supporting the provider's treatment plans
- Improving patient appointment show rates
- Facilitating communication and integration between behavioral health and medical providers by coordinating wraparound services
- Coordinating discharge planning
- Facilitating access to non-covered community resources for patients
These teams allow the administrative structure and practices to be centered on supporting integrated delivery of all services, including physical health and behavioral health, through the strategic alignment and organization of all administrative functional areas providing:
- Synchronized organizational and operational structures to ensure that meaningful data will be collected and integrated across client functional units
- All major operational areas remain functionally integrated
- A management structure that supports the integrated care model
- A multidisciplinary care coordination function that can be executed by providers who will be actively engaged through initial and ongoing training and communication
Envolve implements an integrated care management and service delivery model and processes to identify and respond to what is important to each patient, including strengths, goals and cultural considerations.