The Upper Peninsula Health Plan’s (UPHP’s) complex case management (CCM) program is designed to help you in managing the care of your members who have diabetes, congestive heart failure, high-risk pregnancy, hypertension, uncontrolled asthma, chronic pain, or other complex conditions. The program’s objective is to help members with chronic and complex conditions to obtain access to care and obtain services needed to help them self-manage their disease.

CCM clinicians help to identify members and provide support and interventions. They complement the primary care provider’s plan of care to help members to better manage their individual complex diseases.

Clinician interventions include:
 

•   Care coordination between providers.
•   Individualized plans of care with short-term and long-term goals.
•   Care coordination between providers and community organizations.
•   Transportation help when needed (for UPHP Medicaid members only).
•   Telephone calls to members.

The role of the CCM clinician is to support the plan of care set by providers. This program supplements that plan of care to help members achieve the best outcomes possible.

If you have a member patient whom you feel would benefit from the CCM program, call Clinical Services at (906) 225-7921 or 800-835-2556. To refer a member, you may also download and use the Clinical Services Care-Coordination/Case-Management Referral Form.

•   Care-Coordination/Case-Management Referral Form