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HealthChoices MembersMiembros de HealthChoicesUPMC Health Plan Members |
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Guiding PrinciplesWe support the transformation of behavioral health services as they become increasingly recovery-oriented and focused on instilling hope, dignity, personal growth, responsibility, adaptability, and the capacity to live successfully in the community. Over the past 10 years we have worked to design and improve access to services that reflect this transformation; during this time we have increased the number of HealthChoices consumers who receive services by more than 300%. When we work with our stakeholders to design services, we follow five guiding principles: 1. Ensure that a comprehensive continuum of care is available, including outreach to un-served and underserved populations. 2. Enhance the recovery/resiliency focus of all services. 3. Encourage and support the implementation of best practice guidelines and evidence-based practices. 4. Ensure coordination of care across agencies, funding sources, and physical and behavioral health. 5. Make use of technology to manage consumer, quality, and outcomes data. To ensure that our services accommodate the unique needs and characteristics of our consumers we rely on continuous personal collaboration and advanced data analytics. Ongoing Consumer and Family CollaborationPersons who have behavioral disorders (and their families) are the center of the service system. It is vitally important to have continuous, active involvement of consumers and their families in the design, implementation and evaluation of the system of care. Our strategies for involving consumers and their families are multi-faceted and include membership on the Board and other committees, as well as serving in advisory capacities to Community Care. Through all of the committees – but particularly the Quality and Care Management and Outcomes Committees, as well as the Member and Family Advisory Committees of Community Care – consumer and family input helps shape the service system. We understand that persons (and their families) who are in need of behavioral health treatments and support services are experts on the system that serves them, and are critical in making recommendations for improving the service delivery system. Data AnalyticsCommunity Care uses data analytics to better understand the unique characteristics of our public sector members. Understanding the specialized needs and preferences of the membership is Community Care’s foundation for providing appropriate care and services, maintaining an adequate provider network and delivering care and service in a culturally sensitive manner. Community Care’s information technology and collaboration with our partners also enhances our ability to utilize both claims and clinical data for the purpose of outcomes studies. Community Care conducts extensive quality management and improvement efforts. Additionally, it has developed an outcomes agenda that focuses on understanding and improving services to our most vulnerable consumers. |
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