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Care Coordination

Care coordination is a service that aims to streamline and enhance the delivery of healthcare services for individuals, particularly those receiving or eligible for Medicaid.

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Care coordination is a service that aims to streamline and enhance the delivery of healthcare services for individuals, particularly those receiving or eligible for Medicaid. This approach involves managing and organizing the various aspects of a person’s care to ensure that they receive comprehensive and effective support. Services covered under care coordination for Medicaid recipients may include:

  • Assessment and Planning:


    Care coordinators conduct comprehensive assessments of a person's health, social, and environmental needs. They work with healthcare providers to develop individualized care plans that address these needs.

  • Referrals and Access to Services:


    Coordinators help individuals access a range of healthcare and social services, including primary care, specialists, mental health services, and community resources. They facilitate referrals and ensure timely appointments.

  • Medicaid Enrollment and Navigation:


    Care coordinators assist individuals in understanding and navigating the Medicaid system. This includes helping with the application process, ensuring eligibility, and explaining available benefits and coverage options.

  • Medication Management:


    Coordinators play a role in managing medications, ensuring that individuals understand their prescriptions, adhere to medication schedules, and receive necessary refills. They may also coordinate with pharmacies to streamline this process.

  • Communication and Collaboration:


    Care coordinators serve as liaisons between different healthcare providers, ensuring that information is shared and coordinated among the medical team. This promotes a more cohesive and integrated approach to care.

  • Care Transitions:


    Coordinators assist individuals during transitions between healthcare settings, such as hospital to home or nursing home to community living. This helps prevent gaps in care and reduces the risk of hospital readmissions.

  • Advocacy:


    Care coordinators advocate for the needs and preferences of the individual within the healthcare system. They work to ensure that services align with the person's goals and promote their overall well-being.

  • Health Education:


    Coordinators provide education on managing chronic conditions, preventive care, and healthy lifestyle choices. This empowers individuals to actively participate in their own care and make informed decisions.

  • Social Support Services: 


    Care coordination often includes linking individuals with social services, such as transportation assistance, housing resources, and support groups, to address broader social determinants of health.

  • Monitoring and Evaluation:


    Coordinators regularly assess the effectiveness of the care plan, making adjustments as needed. They monitor health outcomes, identify potential challenges, and work proactively to address emerging issues.

  • Care coordination under Medicaid is designed to improve the overall quality of care, enhance the patient experience, and reduce unnecessary healthcare costs by fostering collaboration among various healthcare providers and community resources.

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    Why we are so trusted

    Learn why Metro Elder Care is the trusted choice for reliable and compassionate Elder Care Services.

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    A successful resolution and financial savings would not have been possible without their expertise. I am immensely grateful for their help and their willingness to “go the extra mile” and I have recommended their services to other friends and family in need of advice......

    Werner K.

    We want to thank you for your professional service and personal attention to us. What we thought would be a difficult and overwhelming task turned out to be a pleasant experience. We highly recommend Metro ElderCare......

    Henry C.

    Elaine and her staff are exceptional! Their knowledge and care made a very difficult process as “easy” as it could be. My family and I thank you Elaine, and everyone in your office......

    Jennifer S.

    Each time I get an email from you I am reminded of how grateful I am for your services on behalf of my cousin Paul and his wife Angelique. God has given you tremendous gifts in organizing, navigating, and connecting with people in need and you all use them so beautifully. I wonder if you know how many lives you have touched and made better by sharing your gifts? Let.....

    Mary (on behalf of Paul and Angelique)

    We can’t thank Metro ElderCare enough! Their patience, professionalism, and kindness are unparalleled! Our family highly recommends them. Thank you!.....

    Patrick T

    My friend Jenny went back to her family in Florida, after staying with me for 8 months, until the Medicaid came. There have been so many twists and turns during this four year journey with Mom. I could never have done it without Metro Elder Care Agency. You, Joy, Elaine and the phone staff have all been so kind, patient and understanding. You have encouraged me at times when I.....

    Tracey T.

    Rarely in the business do you meet people who are honest, professional, do business by a code of ethics and most importantly reliable. I can honestly say that Elaine is who you should call if your family needs help......

    Lenny K.

    On behalf of my Dad, Mom and Laura, I would like to thank you for your professionalism, proficiency and kindness you have afforded us while handling my Dad’s Medicaid case. You turned an overwhelming experience into a very manageable process by walking with us.....

    Charles C