Care Management

Information relating to Martin's Point care management services and health management resources.

Martin’s Point offers the following care management activities:

Chronic Care Management/Disease Specific Management

Members work with a nurse care manager or member of the care management team to better understand their chronic and complex medical conditions, ensure coordination with community providers, improve adherence to treatment plans, manage medications, receive support and advocacy, set goals to improve self-management skills, and connect with community resources.

Transitions of Care

Members work with a care manager after transitioning home from an inpatient setting. The care manager will review the discharge plan, provide patient education, review of signs and symptoms of an exacerbation, complete a medication reconciliation, assist with coordinating services or obtaining needed medical equipment, and confirm follow-up appointments with providers and connection with community resources. Transitions of care outreach is available for members discharged from both medical and behavioral health inpatient stays.

Behavioral Health

Members with either a mental health or substance use diagnosis work with a social work care manager who provides support and advocacy, patient education, collaboration with providers or assistance finding therapy or rehabilitation services, connection with community resources, and uses motivational interviewing techniques to drive behavior change and improve self-management skills.

Maternity

Members work with a nurse care manager to receive maternal health support and education during and after pregnancy to promote positive health outcomes for both mothers and newborns.

To refer a member to a care manager at Martin’s Point, visit our Forms and Documents page or call 1-877-659-2403.

Extended Care Health Options (ECHO)

Extended Care Health Options (ECHO) program provides supplemental services for active-duty family members with qualifying mental, developmental, or physical disabilities.

Echo offers integrated services and supplies beyond what is covered under TRICARE plans.

Our care managers can assist with the ECHO registration process and assist with resources and services needed.