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Support for Member Health Care Needs 

The Denver Health Medical Plan (DHMP) Care Management team is here to help members with their health needs. Care Management programs are no cost to members. Members who would like to self-refer to any of these Care Management programs may call 303-602-2184 or email Care Management at DHMPCC@dhha.org to learn more or get started.

Complex Case Management 

This program helps members with complex health care needs. Care managers support clients with coordinating health care services and benefits. Coordination of care starts with a care plan. Complex care managers help members get access to health care services. Case Managers give support for health choices. The DHMP Complex Case Management program empowers members to manage their own health.

Members enrolled in the Complex Case Management program will have an initial assessment. The assessment captures up to date health status and health-related needs. The assessment will help in the development of a care plan. The care plan will allow members to set their own health care goals. The plan includes both prioritized health goals and self-management goals. Care plan goals are communicated with the member along with a follow-up schedule for next appointments. 

  • Assessment and member-driven care plan that captures:
    Current health status
    Clinical history
    Mental health needs
    Activities of daily living
    Psychosocial needs
    Life planning needs
    Cultural and linguistic needs
    Visual and hearing needs
    Caregiver involvement
    Prioritized member goals
    Self-management goals
  • Support with scheduling appointments, appointment reminders, and referral coordination
  • Benefit coordination
  • Support with scheduling rides
  • Referrals to community-based groups
  • Linguistic services
  • Support for members after a hospital visit
  • Coordination of in-home services, such as health and durable medical equipment
  • Member education and support for disease management

Complex Case Management is a no-cost program to members. Members may opt in through self-referral and may opt out at any time. Members who would like to self-refer to our Complex Case Management Program may call 303-602-2184 or email Care Management at DHMPCC@dhha.org.

Transitions of Care Program

This program supports members who have recently discharged from a hospital visit. Care Managers in this program call members after a hospital visit to offer resources, information, and support. Members who opt into the program will get support from Care Managers for 30 days. An assessment is done to find out member needs and to make a member-driven care plan. At the end of the 30-day program, the Care Manager will either graduate the member or guide the member on to another care coordination program if the member wants ongoing support from care management. The Transitions of Care program can help with these services:

  • In-network provider coordination
  • Appointment reminders
  • Support with setting up home health services and durable medical equipment
  • Support with medications and pharmacy needs
  • Disease management
  • Education and support
  • Support with scheduling rides to provider visits
  • Community-based referrals

Transitions of Care is a no-cost program to the member. A Transitions of Care Nurse will call members after a hospital stay, but members may also opt in through self-referral and may opt out of services at any time. Members who would like to self-refer to our Transitions of Care Program may call 303-602-2184 or email Care Management at DHMPCC@dhha.org.

Condition Management Programs

DHMP Care Management offers specific programs to help members manage chronic health issues:

  • Our Blood Pressure Program focuses on improving blood pressure control through education, support, monitoring, and appointment coordination.
  • Our Diabetes Program is designed to help the health of members with diabetes through education and support, better engagement with health care doctors, lifestyle and behavior changes, access to mental health services, and referrals to peer support programs and other community-based support.
  • Our High-Risk Maternal Care Program is available to Medicaid Members and helps members improve access of early prenatal care, provides education and support, coordinates community-based referrals, and assists with rides to provider visits. DHMP’s Care Management Team works directly with the Women’s High-Risk Clinic at Denver Health Hospital Authority (DHHA) to provide screening and access to mental health and other services within the clinic.
  • Our Special Health Care Needs Program focuses on coordination of benefits and care for members with special health care needs. The program supports access to care, coordination of waivers and other benefits, access to private duty nursing (PDN) and pediatric long term home health services (PLTHH), access to community-based resources and support with getting rides to provider visits. Care Managers work directly with members to create a member-driven care plan.
  • Our Foster Care Program is designed to support the specific needs of members in foster care. Care Managers work directly with DHHA’s foster care clinic to improve access to services, including safety exams for members entering foster care. Care Managers provide wrap-around services to support the unique needs of members in foster care.

Condition Management Programs are offered at no-cost to the member. Members may opt in through self-referral and may opt out at any time. Members who would like to self-refer to a Condition Management program may call 303-602-2184 or email Care Management at DHMPCC@dhha.org.

Care Coordination Services

Care Coordination Services are offered to members who would like support in taking charge of their health care, but who may not fall into other program within Care Management. Services include:

  • Applications/membership Support
  • Community resource support
  • Disease management
  • Education
  • Health needs assessment
  • Medication management
  • Health care provider coordination
  • Help with getting rides to provider visits
  • Appointment reminders
  • Support with food security

Care Coordination is a no-cost service to the member. Members may opt in through self-referral and may opt out of services at any time. Members who would like to self-refer to Care Coordination Services may call 303-602-2184 or email Care Management at DHMPCC@dhha.org.

Substance Use Disorder (SUD) Care Coordination Program

This program supports members in guiding through the recovery process. Services include:

  • Referrals to community support
  • Member education
  • Referrals to programs
  • Help with housing, transportation, education
  • Support with coordinating care and services for body and mind
  • Coordination of approved treatments, support groups, and/or community programs

The SUD Program is a no-cost program to the member. Members may opt in through self-referral and may opt out of services at any time. Members who would like to self-refer to the Substance Use Disorder program may call 303-602-2184 or email Care Management at DHMPCC@dhha.org.

Behavioral Health Care Coordination Program

This program promotes health by helping members access appropriate treatment and community support.  Care Managers help members in making goals focused on improving their health. Although behavioral health care managers do not provide counseling or mental health treatment services, they do work with the member to make a self-management plan, coordinate behavioral health care, prepare the member for interaction with providers to enhance treatment results and help communication between behavioral health and physical health providers. Other services in this program include:

  • Referrals to community-based programs
  • Improve access to treatment
  • Follow up with members with coexisting medical and mental health needs
  • Provide support with medical transportation

The Behavioral Health Care Coordination Program is a no-cost program to the member. Members may opt in through self-referral and may opt out at any time. Members who would like to self-refer to the Behavioral Health Care Coordination Program may call 303-602-2184 or email Care Management at DHMPCC@dhha.org.

Continuity of Care Program

This program supports members who need access to out-of-network providers. Care Managers make sure that new members in active treatment with an out-of-network provider has access to care. The Care Manager helps the member with getting approval for out-of-network care for a period to reduce disruptions and gaps in care. Care Managers work with members to find in-network providers and coordinate a smooth transition between old and new providers.

The Continuity of Care Program is a no-cost program to the member. Members may opt in through self-referral and may opt out of services at any time. Members who would like to self-refer to the Continuity of Care Program may call 303-602-2184 or email Care Management at DHMPCC@dhha.org.