Care Management
Care management is a collaborative process which assesses, plans, implements, coordinates, monitors and evaluates the options and services to meet an individual’s complex health needs, using communication and available resources to promote quality, cost effective outcomes.
Criteria for Eligibility for Complex Case Management
- Neuromuscular condition with major impairment/deterioration
- Severe physical trauma in past 3 months, inpatient 6 or more days, transitions in level of care anticipated
- Stroke within past 3 months, major impairment
- Severe spinal cord injury within past month, major impairment
- Pediatric members with 2 or more inpatient stays in last 6 months, not connected to services
- Other complex care situations which result in extensive use of resources (i.e. multiple uncontrolled chronic illnesses or complex medical condition and complex social situation)
Make a Referral for Care Management
Use the link below to complete our online Care Management & Health Promotion Referral Form for BadgerCare Plus referrals.
Helping Members Stay Healthy
Care Management Programs at Chorus Community Health Plans (CCHP) help our members, and their families build healthy habits. These free services are especially helpful for those living with chronic or complex conditions.
CCHP offers several specialty programs designed to support members with unique health needs. All services stay confidential and are tailored to each member's specific situation. A few of our programs include:
- Asthma Program: Education, environmental trigger management, and action planning support for kids.
- Behavioral Health Program: Coordination with mental health providers and help navigating available services.
- Diabetes Program: Nutrition tips, activity planning, and blood sugar tracking for adults.
- Pregnancy and Newborn Program: Guidance throughout your pregnancy, including postpartum and newborn care.
- Social Navigation: Support with everyday challenges that can affect well-being—like housing, food, transportation and financial stress.
Each program provides simple guidance and personalized tools. Members can also work one-on-one with a care manager who understands their goals. Eligible members can join a health program at no cost and members who qualify can begin using these services right away.
Explore details on how Care Management Programs can help support your patients' wellness journey.
Healthy Mom, Healthy Baby
Our Healthy Mom, Healthy Baby program supports members who are pregnant have a healthy pregnancy and baby. Care managers specially trained in pregnancy and infant health connect members to important community resources; reinforce education on pregnancy, postpartum and infant care; and help navigate a variety of healthcare and social needs. Timely identification of pregnancy helps us best meet our members’ needs. Please complete the Notification of Pregnancy form and fax it to 414-939-8052.
For more information about the Healthy Mom, Healthy Baby program, the Notification of Pregnancy incentive program for providers, incentives for our members, or to refer a member, contact us at healthymomhealthybaby@chorushealthplans.org.
Asthma and Diabetes
The Asthma and Diabetes programs within CCHP are designed to improve the health of individuals with specific chronic conditions. We help our members learn how to live well with a chronic condition and assist them with obtaining medication and medical supplies, ensuring the necessary follow-up care, and making desired lifestyle changes. We also help our members manage their conditions to reduce avoidable complications, such as emergency room visits and hospitalizations. We appreciate referrals for members living with asthma or diabetes that we can help!
Behavioral Health
Our behavioral health program recognizes that mental and emotional well-being are just as important as physical health. If you notice changes in your patients’ mental health, we provide a range of resources, support, and medication-free treatment options to help you assist them.