Primary Care and Prevention Focused Care Model (PCPFCM)
What You Need to Know:
Your Primary Care Provider (PCP) relationship is important to your overall health. Our new PCPFCM creates a “dynamic duo” between you and your primary care provider in your quest to be a Health Hero. Your PCP in consultation with you, will assure that you get the care you need when you need it. The more your primary care provider gets to know you, your family, your medical circumstances and individual needs and preferences the better your overall care will be.
Provider-Driven Care Coordination
The PCPFCM encourages you to see your PCP regularly even if you are not sick. This approach will support you as a whole person, assist with coordinating your care, and make available appropriate screening test and visits designed to keep you healthy, address barriers to staying healthy, such as housing or food challenges, and support a high quality of life and health for you and your family.
Learn more about Care Management Support below.
How to Get Started:
Prevention is the key to living a healthy and happy life and you can unlock that door with your PCP. Be a Health Hero today and follow these simple steps to getting and staying healthy.
- Make sure NH Healthy Families knows who your PCP is. If you do not have a PCP, contact us and we will help you find one. You can also view our Provider Directory online.
- Contact your PCP to schedule an annual wellness visit or let us help you make an appointment.
- Complete a Health Risk Assessment (HRA) (PDF) with your PCP or bring it with you to your wellness visit. There is also one in your welcome packet.
- New to NH Healthy Families? Let us call you and welcome you to the plan. We can help you select a PCP, schedule a wellness visit, and complete an initial HRA screening. It only takes 15 minutes!
- Are you already a valued member with NH Healthy Families? Give us a call to get help on selecting a PCP, scheduling a wellness visit, and completing a HRA screening.
What is a Health Hero and What's in It for You?
- A Health Hero is a member of any age who takes charge of their own health and wellness.
- A Health Hero chooses a Primary Care Provider (PCP) as their partner in their health journey.
- A Health Hero communicates by completing all forms, a Welcome Call, and alerting us to any changes like address changes, PCP changes, pregnancies and more!
- A Health Hero visits their PCP for annual wellness visits, follows their PCP’s advice for prevention appointments like vaccinations, screenings, specialist visits and follow-up visits.
- A Health Hero receives My Health Pays® dollar rewards* automatically, just for participating in healthy activities like Welcome calls, annual Wellness visits, screenings and more!
- A Health Hero uses their My Health Pays® dollar rewards* to shop at Walmart.
Earn Dollar Rewards* for Preventive Activities with My Health Pays®
My Health Pays® is a wellness program that awards dollars* to Health Heroes. Completing your Welcome Call, your forms, PCP Wellness Visits, screenings, and activities for both physical and behavioral health can earn you up to $250* every year. Start earning today! Still have questions? Contact us today! 1-866-769-3085.
*Some restrictions and limitations apply. Each member can earn up to $250 in cash and non-cash goods and services through June 30 each year.
NH Healthy Families understands you may need assistance navigating the healthcare system. We offer care management services to assist with scheduling appointments, arranging for transportation, housing, and connecting you with community resources such as food stamps, utilities, and support groups.
Care Management is available for all participants. You or your doctor can refer for care management services. You will be assigned a primary care manager who will contact you through the method of communication you prefer, at a time you choose as well. Your care manager will work with you, your PCP, all of your other providers, your family and caregivers, and other health insurance you have to make sure that you get all of the series that you need. We will develop a plan of care and share this plan with your PCP or provider(s). The plan of care has goals for you to work towards. There is no fee or charge to your participation, and you can choose to dis-enroll at any time.
Our Care Managers are registered nurses, behavioral health clinicians or social workers. They help our members understand major health problems and assist in arranging members’ health care needs. Care Managers work with members and their providers or doctors to help identify barriers and support the provider’s plan of care. We also will provide support to your caregivers and family members taking care of you if needed.
Members enrolled in care management often see several doctors. They may need medical supplies or help at home. NH Healthy Families’ Care Managers can assist members in coordinating aspects of their care. Members enrolled in Care Management often have conditions such as, Organ Transplants, Cancer, Hemophilia, Depression, Bipolar Disorder, Autism, and/or Breathing Problems.
Your care manager will also help you when you are leaving the hospital or other short-term medical setting to make sure you get the services you need when you get home. These services may include home care visits or therapies. If you need help with any part of your health care services or with connecting with another state or local program, please call your care manager or Case Management Department at 1-866-769-3085.
In addition to Care Managers, NH Healthy Families has Coordinators who specialize and work with Care Managers in coordinating care. These coordinators are dedicated to the following issues: Developmental Disabilities, Special Care Needs, and Housing Needs. Through our Transition Services program, Coordinators also contact members who have admitted or readmitted to acute care hospitals to make sure you have a successful transition back into the community.
New Members: Your chosen PCP, or the PCP that has been assigned to you is indicated in your member packet. If that PCP differs from who you are currently seeing, or would like to see, we can help!
Existing Members: If you can’t find your PCP, or if you want to change your current PCP for any reason, we can help!
- Contact the PCP you want to see to find out if they are accepting new patients
- Phone: Call Member Services to make the change in our files 1-866-769-3085 OR
- Online: Log into your secure portal to update your PCP OR
- By Mail: Complete and mail the PCP Change Form (PDF) to us
For a list of PCPs in network, view our Provider Directory.