In 1998, Gaston Family Health Services created the organization called Community Health Partners to implement the Carolina ACCESS II Primary Care Case Management program. Community Health Partners (CHP) is one of fourteen regional networks in the state affiliated with Community Care of North Carolina which is charged by the NC Department of Health and Human Services to improve patient outcomes and reduce Medicaid expenditures for high-risk and high-cost patients. Cost containment is achieved by nurse care managers assessing patients’ needs, identifying and coordinating care plans, educating patients on the appropriate use of services, and promoting patient self-management for various chronic conditions. CHP works in collaboration with primary care providers (serving as the patient’s medical home) to implement best practices, evidence-based guidelines, and quality improvement initiatives. There are 60 primary care practices participating in the CHP network serving over 49,000 patients.
Through its role in successfully establishing and operating Community Health Partners, GFHS created a strong support system for building patient-centered medical homes. CHP has several initiatives underway including behavioral health integration, pregnancy home for high-risk maternity care, and transitioning patients from the hospital to another setting of care.
CHP’s expertise in population health, patient engagement, chronic care management, advance care planning, transitional care, and quality improvement makes it a strong resource helping primary care practices prepare for a value-based payment system.
Watch the following video about Commmunity Health Partners:
For additional information about Community Health Partners, call 704-874-1920 or visit the CHP website at: www.communityhlthpartners.org