Common use of Complex Care Need Clause in Contracts

Complex Care Need. Enrollees who are determined to have significant health care needs and require intensive care coordination services/activities geared towards addressing their physical, behavioral health and/or social care needs. These Enrollees typically have co-morbidities and psychosocial needs that if not addressed can significantly diminish their quality of life as well as their ability to adhere to treatment plans. Care Coordination services for these Enrollees are typically provided by a licensed registered nurse or other individuals licensed to provide Clinical Care Management, as these Enrollees typically require very individualized services tailored to their needs and stage of readiness with a goal of averting the need for more intensive medical services.