Special Needs & Expensive Complex Care Management Program

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Medicalincs has extensive experience in providing complex care management programs that support individuals with specified rare and expensive conditions, with an integrated primary care support & community-based methodology. This provides the patient access to appropriate, high-quality, cost-effective, care coordination. Individuals who are eligible for Special Needs & Expensive Complex Care Management Programs must also be eligible for Medicaid and have a qualifying diagnosis. Eligible individuals can be referred by anyone or entity that identifies the qualifying diagnosis. A clinical assessment is done to confirm your eligibility and to initiate services. Our experience includes working with State Programs (such as the Maryland REM Program) and also with Managed Care Organizations (MCOs).

Services Covered

Special Needs & Expensive Complex Care Management Programs usually cover a wide array of services. The Medicalincs Care Management Team provides individuals with a person-centered, specialized, integrated, positive, care management experience by coordinating their services to improve their access to appropriate, high-quality care.

Eligible individuals are able to receive all Medicaid-covered services (as shown below), and additional services as medically necessary such as nutritional supplements and private-duty nursing & nursing assistance.

Selected Programs:

COMCARE Program

Medicalincs supports a special needs complex care management program that is embedded in an advanced primary care model that caters to special needs children. As a Care Transformation Organization, Medicalincs provides integrated primary care & community-based services to ensure equitable, person-centered, care management support.

REM Program

Medicalincs served as a multi-year REM Provider for the State of Maryland. The Rare and Expensive Case Management (REM) Program is a case managed service alternative, that is part of the Maryland Medicaid HealthChoice Program. The REM Program supports individuals with specified rare & expensive conditions.

CARES Program

Medicalincs engineered a new line of business to support Managed Care Organizations (MCOs) with (delegated) Complex Care Management services for individuals with rare and expensive conditions. This requires a well-rounded understanding of the Managed Care, Care Management requirements to provide quality care and meet target quality measures.

Management Team Spotlight:

Njideka Ajemba

Clinical Manager

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