CCS Health
Solutions

We offer ready-built solutions for every stage of a partner’s care coordination journey from start-up community groups to multi-agency community or localized HUBs and robust, multi-agency HUBs. Every partnership and community is unique, which is why every package is customized to meet your needs.

Through our initial consultations, we work with partners to understand their current operations and aspirations. From there, we recommend one of our three size-based solutions (Accelerate, Fortify, or Bridge) and work with you to personalize it. This allows partners to mix and match from a menu of robust tools, ensuring that your CCS Health solution perfectly meets the needs of your workforce and the communities they serve.

Advisory and consultative support is offered through the implementation of all of our solutions, helping teams and organizations accelerate and model best practices from the beginning.

A Proven Model for Successful Community Health Solutions.

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Identify and assess clients’ needs.
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Assign individual care plans for risk factors, establish access to care.
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Monitor and update real-time analytics for successful outcomes.
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Link individual and population metrics to decision makers for health care and public policy.
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Bridge is designed with more complex care coordination in mind, bringing together multiple HUBs and agencies into a cohesive state-wide or regional system. With a consolidated view across multiple communities in a larger area and the capability to drill down comes the ability to be more strategic. Bridge can combine any number of our advanced tools, allowing statewide departments and government entities down to individual agencies and teams to do more with the data and details already collected.

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Fortify is ideal for moderately complex operations such as a new or existing HUB or multiple collaborating agencies. Combine any number of our advanced tools to strengthen and simplify the interconnectedness between care coordination entities and providers in the community. CCS Health’s Fortify enables your teams to spend more time doing the work that matters.
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Accelerate is ideal for partners with simpler operations such as a single team, organization, agency, or group. Simple does not mean less impactful. Accelerate may combine any number of our advanced tools, allowing care coordination professionals to take advantage of CCS Health’s sophisticated technology and data offerings, even as the active caseload and community relationships grows.

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Our purpose-built solution was designed to run alongside the Care Transitions Intervention®, enabling Transitions Coaches and providing agencies to easily tell their impact story to the referring organizations and payors.

Maximize the data already captured as part of the standard intervention to increase outcome-based payment, demonstrate results and impact, identify quality improvement areas, and more. Custom-built to run alongside CTI®, CTI+ makes it easier to track and manage clients’ progress in areas such as patient activation and self-management, and quickly process invoices through the entire intervention cycle.

Advanced Tools at Your Fingertips.

Our agreements and partnerships with industry leaders make us a one-stop shop for all of the tools a community-care professional might need to transform health in their community—all within a single CCS Health solution.
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Patient Activation Measure (PAM)

Measure each client’s knowledge, skill and confidence in managing their health and navigating the healthcare system with the support of a simple survey, and then track their progress over the course of their interventions and interactions with your team.
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Health Education Resources

We have partnered with the world-class health content and patient education provider, Healthwise, to provide health education resources alongside CCS Health solutions.
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Reporting

Take advantage of the power of Tableau’s interactive data visualization with standard and custom-built reports and dashboards designed to show the data you need and care about for decision-making and presenting to funders.

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HealthBridge.care®

Assess clients’ needs, make and manage referrals to resource partners in the community, and monitor successful completion of referrals.

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Invoicing

Recoup a higher percentage of outcome-based payments, invoice and secure payments–individually or in bulk–with just the click of a button, and create sustainability.

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Community Health Record (CHR)

CCS Health’s flagship technology provides scaleable case management capability. Create and assign tailored individual care plans and education based on risks, establish access to care, and track progress over time without paper shuffling.

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Closed-Loop Referrals

Our tech-enabled workflow provides visibility to a client’s real-time progress through the referral lifecycle from the time the need is identified, to finding and referring to the appropriate service partner and verifying the client has connected.

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Forms

Custom or standard forms (e.g., pregnancy, substance abuse, depression screening, etc.) allow you to quickly and easily capture client information to track intervention outcomes, identify community need trends, collect reimbursements and report out to funders.