Eligibility, Enrollment, and Case Management Solution for San Francisco and 35 California Counties
San Francisco and a consortium of 35 California counties provide primary and preventive healthcare to an otherwise underserved population of adults and families. To provide better service to their clients and better support their staff, they needed an integrated, secure, and easy to use modern eligibility, enrollment, and case management platform for their vital programs.
The healthcare program in San Francisco is aptly named, Healthy San Francisco. Managed by the City’s Department of Public Health (DPH), it offers affordable health coverage to over 160,00 low- and moderate-income families residing in San Francisco.
California’s County Medical Services Program (CMSP) manages a similar initiative. The CMSP focuses on lower income adults in 35 California counties, from Humboldt and Mendocino to Inyo and Imperial.
Both programs are designed to help promote timely delivery of medical services, reduce the use of emergency services, and decrease inpatient hospitalizations.
With an eye toward improving the client experience, making it easier for staff to capture applications and determine eligibility, and reducing the time it takes to get a client enrolled, San Francisco and CMSP partnered with RedMane to implement the firm’s cloud-based human services platform called mCase.
A Win for All Stakeholders
RedMane, working collaboratively with San Francisco and CMSP over just a few short months, configured mCase to meet their demanding requirements. Because mCase is built on a no code/low code platform, the solution could be tailored to the exact needs of each program. And, with its Service Oriented Architecture (SOA), integration between mCase and carriers was a breeze.
The result is a win for all stakeholders. Clients get the assistance and healthcare they need in a timely manner. Staff can focus on service, as mCase handles the complexity of rules, processing, and data integration. Program leadership gets real time metrics to better inform policy and outreach decisions, all via mCase’s dashboards and reports. Oversight organizations can get insight into operations through mCase’s modern security and audit capabilities. And, because mCase is built for change and is easily adaptable to changing needs, San Francisco and CMSP have confidence they can adjust their program and practices to the evolving needs of their communities.