Connecting Care, Empowering Communities

Transforming Whole-Person Care With The Community Health Record (CHR™)

As a leader in care coordination technology and services, CCS Health’s Community Health Record (CHR) is an all-in-one SaaS solution that delivers real-time reporting — enabling data-driven decisions and providing actionable insights exactly when you need them.

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This powerful, centralized platform brings everyone to the table between healthcare, social services, and community organizations — enabling a more connected, coordinated, and person-centered approach to care, effectively addressing the full spectrum of individual and community needs.

Key Advantages

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    Out of the Box Solution: The "out-of-the-box" solution of the CHR includes evidence-based care models, health-related social needs (HRSN) and clinical assessments, screening tools, referral management, and templates.

    Configurable workflows align with funding needs, while automated workflows reduce errors and gaps in care, prioritize care plans, and support quality of care.

    As a leading platform for interoperability, the CHR connects real-time information to major systems, enabling seamless coordination across sectors.

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    Robust Care Coordination Tools: Multidisciplinary teams can manage referrals, track progress, and collaborate in real time across sectors — ensuring that no one falls through the cracks.

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    Centralized Data Sharing: Break down silos with secure data sharing that ensures only the necessary information is shared. Seamlessly integrate clinical, social, and community data to give every member of the care team a complete picture of the whole person — helping to deliver more coordinated, uninterrupted support.

    Care can be coordinated across all settings and locations, with a shared history and record that supports consistency. Clients aren’t asked the same questions repeatedly, reducing redundancy and preventing burnout for both individuals and care teams.

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    Powerful Outcomes Tracking: Identify risks, measure health improvements, track social and medical access and engagement, and program effectiveness with actionable analytics that support value-based care and demonstrate real community impact.

    Allows organizations to ensure programs align with business and mission priorities, track quality measures, visualize real-time data, track client/patient satisfaction, and view the client’s care across multiple programs/agencies with one record.

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    Invoicing: Bill health plans, authorize and track payments to community based organizations (CBOs) – Get reimbursed by health plans for work and care coordination efforts, then distribute payments to CBOs for services provided.

    The system supports various invoicing models, including value-based, outcome-based, time-based, and capitated. The CHR streamlines the billing process, supporting organizations in billing health plans and paying out to sub-contracted agencies. The CHR bills and pays out — promoting accountability and incentivizing interventions and programs.

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    Proactive Risk Identification: Utilize proven assessments and advanced data insights to identify at-risk individuals early — not all risks lead to crises, but early identification helps prioritize interventions, allocate resources, and guide care delivery to keep people healthy and safe.

    CCS’ RiskQ® supports care teams with real-time risk scoring, enabling informed decision-making and care planning. It also helps organizations capture more revenue through timely, targeted interventions.

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    Privacy and Compliance Built-In: Our platform is built on rigorous privacy and security standards. The CHR is HIPAA compliant and HITRUST® certified so you can focus on your mission.

CCS Health's CHR is more than just technology — it’s a movement toward smarter, more connected, and more compassionate care. By linking healthcare and social service networks, we help communities drive better health outcomes, reduce disparities, and achieve lasting change.