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Care Management

Johns Hopkins HealthCare LLC is proud to offer (at no cost) a one-of-a-kind structure of health management programs for our Priority Partners, Johns Hopkins Employer Health Programs (EHP) and Johns Hopkins US Family Health Plan (USFHP) members. Through a unique design, members are stratified into one of three levels, depending on their acuity. Depending on their level, members are given a variety of support, tools and services that are specifically designed to help them better understand and manage their medical conditions. Some even have the option of working one-on-one with a trained nurse or social worker to help them improve or manage their condition. Our programs and services aim to educate, empower and inform your patients to be engaged in their health care through improved self-management.

Level I: Complex Case Management 

 This level is for members with complex medical conditions, or who have multiple conditions. These members, such as adults and children with diabetes, asthma, chronic obstructive pulmonary disease (COPD), and/or congestive heart failure are contacted by a care manager who will assess their health status, work with them to develop a self-management plan, and assist them in getting the appropriate care.

Level 2: Monitored Case Management

Members who have less complicated conditions (such as less severe asthma, diabetes or cardiovascular disease) but have a risk for developing other conditions or complications, may benefit from ongoing monitoring and help with staying on a healthy track. Health assessment coordinators will track these members’ health status and needs over time, encourage progress toward their health goals, and periodically give them health information about exploring and maintaining a healthy lifestyle.

Level 3: Lifestyle Management

There are some members with conditions that are newly diagnosed or whose status is under control. These members will receive routine mailings with information about their diagnosis. This material will assist in keeping these members’ self-management skills up-to-date so that they continue to live full lives and avoid future complications.

Other services provided by the program include:

  •  Periodic mailings of health educational materials
  • Communicating to the member and health care provider about medical and pharmacy claims
  • Use of the TeleWatch Health Monitoring System which allows members and their health care providers to monitor health conditions by telephone
  • Review of medications and discussion with our clinical pharmacists if needed
  • Assistance with getting behavioral health services; this service can be reached by calling the toll-free number 1-888-309-4573
  • Outreach to eligible members as they leave inpatient care, ensuring they get the correct follow-up care and needed medical equipment
  • Help with discharge planning, care coordination, and member and family education when moving from a hospital to a lower level of care to home

JHHC encourages providers to take advantage of the three-tiered system of health management program and to refer members whom they think will benefit. To refer someone, or if you have any questions, call 1-800-557-6916 or email populationhealth@jhhc.com.

JHHC's health programs and services are voluntary and are provided at no cost to the member. Members identified with certain needs may be automatically enrolled but are under no obligation to participate

Do you have a patient with a high-risk pregnancy? Help them get the best care possible with our Partners with Mom program. Learn more.

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