Other High-Risk

The goal of our high-risk outreach initiatives is to identify and intervene on those members who are at the greatest risk of deteriorating clinically and incurring high costs within the near term, usually the upcoming year.

Current high-risk initiatives include:

• Specific phone outreach screening mechanisms to provide ER usage education and other care coordination interventions such as; encouragement of PCP relationship, transportation issues and facilitation of physician appointments. This outreach will lead to improved member access to primary care and eventual decrease in ER visits that could be managed through primary care.
• Specific phone outreach to targeted diagnostic categories such as diabetics with an obesity co-morbidity.

For more information of current initiatives, contact Deborah Durning, RN at 401-459-6178.