ComplexCare Solutions

ComplexCare Solutions excels at delivering high-touch, high-value assessment and care management services for health plans nationwide. We are known for our successful in-home member engagement, which allows us to collect a more robust range of data, implement more personalized care plans and motivate change for desired outcomes. Our modular suite of specialized services is designed to integrate with your operations across the entire care management continuum to build a customized solution that helps you stay in compliance, receive appropriate reimbursements, lower costs and improve member satisfaction.

Our executive team members, clinicians and coders bring a wealth of experience and dedication to our shared goal of delivering the best care management solutions in the industry. With decades of working with health plans, large and small, we bring a deep understanding of business challenges to every engagement, and firm resolve to helping you achieve your goals.

We currently contract with three of the five largest national health plans as well as many regional, local and special needs plans. The vast majority of the members we serve are Medicare Advantage, Medicaid Managed Long-Term Care and Dual-Eligibles. We also serve Managed Medicaid, Commercial ACA and General Commercial Populations.

We are ACAP-endorsed, and we provide assessment and care management services across the U.S., including Puerto Rico, with an average daily care management census of over 12,000 members.