Calvert Healthcare Solutions

Program Name: Patient Centered Care Management for Calvert County, Maryland's Vulnerable Citizens

Grant Amount: $287,763/2 years

Calvert Healthcare Solutions, Inc.

Calvert Healthcare Solutions is not a “bricks and mortar” clinic. It utilizes a network of participating physician providers located throughout Calvert County to serve individuals who generate too much income to be eligible for Medical Assistance, yet do not have access to or cannot afford commercial health insurance. The program is run with support from Calvert Memorial Hospital, Calvert County Health Department, Calvert County Department of Social Services and other community agencies.

To establish a patient centered medical home for Calvert County's low-income, uninsured adult population, Calvert Healthcare Solutions will develop individual physician-directed health care plans for clients at high-risk for diabetes and/or heart disease. Program includes subsequent monitoring of measures, wellness coaching, referrals for tobacco cessation, medical education and mental health services, and access to pharmaceuticals through a voucher program with local pharmacies. Clients will be incentivized to complete a health risk assessment. Grant to fund care coordinator, administrative coordinator, grant coordinator, Hispanic staff, specialty care, medications, IT support and a wellness program.

The program will measure “normalized" blood pressure, blood glucose readings; increased disease self-management skills, physical activity; completed health plans; decreased hospitalization occurrences; use of ER visits for diabetes, cardiovascular disease; appropriate referrals to other resources and improved self-reporting for mental health perception.

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