Care Coordination is the process of linking patients with resources to
facilitate access to services, promote continuity of care, provide families
with support and improve health. This process includes assessing, planning,
implementing and evaluating options to meet a patient’s medical
needs after discharge, through coordination with physicians, nurses, pharmacists,
behavioral health specialists, insurance plans, community-based organizations and more.
The scope of services delivered under the program will vary based on the
patient’s needs. The designated Care Coordinator will work with
providers, in addition to coordinating between providers and the patients
and their caregivers. Care Coordinators are also available for patients
who also need help with transportation, insurance coverage and applying
for financial assistance.