Pediatric patient at the hospital

Helping Hospitals Discharge Patients Faster

Our Care Coordination program reduces the administrative burden that hospitals experience when discharging behavioral health patients. It's a collaborative program identifying inpatient and outpatient behavioral health care to reduce emergency room overstays and hospital readmissions.

Care Coordination is a single access point for hospitals and community providers to connect, communicate, and act, getting patients the care they need faster.

Coordinated Care

From complex to routine cases, Maryland hospitals can leverage our technology and infrastructure to coordinate, monitor, and track cases.

With a large network of participating hospitals and state and local agencies, we facilitate care coordination across systems with representatives from health and human services agencies and even schools. The majority of referred patients are adolescents. Our comprehensive network of community support can help the patient today and tomorrow.

 

How We Help Hospitals

We can help hospitals improve patient care by reducing hospital overstays and readmissions.

Improve Efficiency of Case Management

Discharge planners can refer and track patient cases, making it easy to identify and communicate a patient's needs, next steps, discharge status, barriers, and outcomes.

Coordinate Care Across Systems

Hospitals can tap into our vast network of state agencies and community providers to communicate and collaborate with providers and care coordinators.

 

Close Complex Cases

Our ability to coordinate across systems allows us to create inter-agency collaboration and consultations that align resources and services across multiple systems

Collecting Data to Drive Decisions

We collect information from the Behavioral Health Authority on hospital overstays, diagnoses, referrals, locations of needs and gaps in services.

This information can inform and drive decisions.

2025 Impact

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Patient Referrals
0%
Reduction in Time to Close a Case (March 2025)

Strong Partnerships Support Patients

We continue to expand and deepen our partnerships with a diverse network of hospitals and community providers.

As we strengthen partnerships, we align systems, enhance collaboration, and streamline care in the often fragmented health and human services ecosystem.

Most Referred Patients

Adolescents aged 13-17 years are referred most to the Care Coordination program. 65% of patients referred are under age 21.

Care Coordinator, Kia Greene, talks about one of those cases where she helped a youth get discharged from the hospital after 100 days.

 

Work With Us

We're hiring care coordinators, including a lead position, to support emergency department patients with community-based behavioral health services, connecting patients and supporting hospitals with patients who have mental health conditions, substance use disorders and developmental disabilities.

Skilled professionals with experience in social work, public health, healthcare, or human services, specifically with experience with Maryland's Public Behavioral Health System are preferred.