Care Coordination Services
Care coordination is the process we use when needs are identified by our team and your providers. We will establish goals with you, and community services are coordinated to help you meet those healthcare goals. Our team of caring and dedicated clinicians at Meadville Medical Center will work with your physicians, healthcare providers, and other agencies to help you manage chronic disease conditions, with a focus on meeting your health and wellness goals. The population health team includes nurses, social workers, health coaches, and access to dietitians.
Services May Include:
- Education and support to manage chronic disease conditions, for example:
- Diabetes
- Congestive heart failure
- COPD
- Hypertension
- Depression/ anxiety
- Chronic kidney disease
- Help to ensure medication lists are updated for you and your providers, and being taken as ordered
- Help with appointment scheduling and reminders
- Assistance with scheduling behavioral health and counseling services
- Coordinate with pharmacies or other community agencies that will fill and deliver medications
- Help coordinate medical transportation for appointments for those that qualify
- Diet and nutrition education; can provide recipes and teach cooking skills, if needed
- Assists with completion of paperwork for community services
- The opportunity for Allegheny College students to work with clients on health goals
Additional Information
Who Qualifies for this Program?
Patients who use Meadville Medical Center providers for their regular ongoing medical care may qualify for care coordination support. There is no income limit. If you have any health conditions that you manage at home, you may be a candidate for coordination services.
Is This the Same as Visiting Nurses?
No. Visiting nurses will provide short-term skilled nursing and therapies (hands-on care) to patients in their homes, whereas Population Health provides ongoing support services to help you improve your health and meet your long term health goals.
Common Community Resources
For safety and sanitary reasons, it’s important to rid your home of pests, like bed bugs, before our providers can enter your home as well as before you come into medical facilities for your appointments!
For your convenience, we have compiled a listing of local companies who specialize in pest control. Click the button below for a flyer with contact information.
Active Aging offers programs and services for Crawford County residents age 60 and older. Some of these offerings include educational events, nutritional vouchers, housing programs, exercise classes, caregiver support, and more. There are 5 Active Aging Centers around Crawford County. Learn more at: ActiveAging.org.
Crawford County Mental Health Awareness Program, or CHAPS, provides support to those dealing with mental illness and substance abuse disorders (SUD). A major aspect of their work also includes housing advocacy and support, providing resources for those who need help in accessing and maintaining affordable, permanent housing. Learn more about their programs and services at: CHAPSInc.org.
* CHAPS also maintains a list of community resources and related links on their website!
Crawford County Human Services provides and collaborates with mental health providers as well as services for intellectual disabilities and early intervention for children and youth within our community. More information, including contact information, can be found on their services overview at CrawfordCountyPA.net.
PA 211 is a free resource provided by the United Way of Pennsylvania to connect with resources your local community, including ones for utilities, housing assistance, food, and more. Resource specialists are also available by phone or chat.
Contact Population Health
