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Comprehensive Care Management helps streamline care and improve client outcomes. 

Managing multiple chronic medical conditions can be difficult and time-consuming. Our comprehensive care management program is designed to help people manage their physical and behavioral health care and lead healthier, more satisfying lives. 

The Bridge offers comprehensive care management services for individuals covered by Medicaid and living with: a) two or more chronic medical conditions; b) HIV/AIDS; or c) a diagnosis of serious mental illness. 

Health Home Care Coordination

The Health Home Care Coordination program helps individuals living with chronic illnesses manage their health and access primary and specialty health care services, reducing reliance on emergency rooms and preventing hospitalizations. 

A dedicated care manager provides services, support, and information, helping clients stay healthy and in charge of their care. The Bridge serves eligible members in Brooklyn, Queens, the Bronx, and Manhattan. 

Our Approach

Understanding that comprehensive health care encompasses physical health, mental health, and general well-being, care managers connect clients to vital community resources for all health care and social service needs. 

The Bridge's comprehensive network of relationships with medical and social service providers throughout New York City allows our staff to be responsive to clients' needs, connecting them to the services that will benefit them most.

Services Offered

Health Home care managers:

  • Help clients select doctors
  • Provide appointment reminders
  • Assist with transportation to and from appointments
  • Help empower clients with information about their own care
  • Advocate for clients to receive the assistance and services to which they are entitled

Eligibility

To enroll in the Health Home Care Coordination program, an adult must have:

  • Active Medicaid coverage
  • At least one of the following:
    • two or more chronic conditions (substance use disorder, diabetes, heart disease, etc.)
    • HIV/AIDS
    • a diagnosis of serious mental illness

Through a contract with New York City's Department of Health and Mental Hygiene, we have a limited number of slots available to provide Comprehensive Care Management Services to individuals who do not have Medicaid.

Intake

For further information, please contact the Health Homes program in your borough.

  • Bronx/Manhattan: please contact us at 212-678-7188.
  • Brooklyn/Queens: please contact us at 718-557-1489.