The Integrated Care Management Program (iCMP) began at Massachusetts General Hospital in 2006 to support our primary care patients with complex health issues. Our initial work was funded by the Centers for Medicare & Medicaid Case Management for High Cost Beneficiaries Demonstration Program. The iCMP is one of many programs available through the primary care practices at Mass General. 

Since 2011, Mass General has supported the expansion of the program and now provides care coordination services to more than 4,000 patients annually. The iCMP team works with our patients and their providers to create a personal care plan to support the patient in achieving optimal health and well-being.

The program helps patients improve their health by identifying barriers to care, which once addressed lead to good health outcomes. Our interdisciplinary team of nurses and social workers identify our patients’ health risks, coordinate care between providers and services, and facilitate communications and transitions between hospital, rehabilitation facilities and home. For some patients this may include reviewing various treatment options or sorting through insurance concerns.

Our patients report that iCMP alleviates the stress and confusion of navigating the health care system by putting key services in place for them, such as visiting nurses and transportation to doctor visits, preventing stress that previously would have triggered emergency department visits. Patients say that through regular telephone contact and meetings when they visit their physician’s office, the iCMP team helps to solve prescription refill problems, improves efficiency and assists with the completion of critical paperwork.

If you feel you would benefit from the Integrated Care Management Program, speak with your primary care physician.