Care Management
Every review, every case and every interaction reflects a real person navigating a real health challenge. State Medicaid agencies face growing pressure to improve outcomes and coordinate care across fragmented systems, even as needs grow more complex and resources stay limited.
Comagine Health® helps states modernize care delivery so members get timely, person-centered care and programs perform sustainably. Our work connects clinical expertise, community relationships and real-world patient engagement, delivered as an independent, neutral partner focused on outcomes.
Core Solutions
Where this work takes shape
Utilization Management
Ensuring appropriate, timely and evidence-based care.
Appropriate care works when decisions are consistent, timely and grounded in clinical evidence. We help states and delegated partners deliver patient-centered utilization management that gets members the right care in the right setting, promotes access for underserved populations and reduces unnecessary administrative burden on providers. The result is stronger quality and safety and responsible stewardship of Medicaid resources.
How We Help
- Evidence-based reviews across physical and behavioral health, staffed by licensed nurses, behavioral health clinicians and physician reviewers
- Faster, more consistent prior authorization decisions that reduce burden on providers
- Audit-ready, defensible processes built for state oversight and federal compliance
- Clinical, social and operational expertise combined in one partner, not three vendors
- Hands-on partnership with states to implement policy changes quickly
Case Management
Closing care gaps for your highest-need members.
Individuals with complex, chronic conditions fall through the cracks of fragmented systems with no single point of coordination. States know who these members are, but reaching them consistently and proving those investments produce meaningful outcomes is harder. Comagine brings the clinical expertise, community relationships and operational infrastructure to close those gaps for the people who need it most. As an independent nonprofit, we operate as a trusted, neutral partner focused on your outcomes, not our own agenda.
How We Help
- Identify, stratify and assign the members who need coordinated support most
- Develop individualized, whole-person care plans that address clinical needs alongside barriers like housing, food and transportation
- Coordinate across providers, payers and community-based organizations
- Reach members where they are, through phone, in-person and community outreach, backed by interdisciplinary care teams of nurses, behavioral health clinicians and care coordinators
- Reduce administrative burden on providers while improving outcomes through continuous monitoring and care plan adjustment
Care Coordination
Strengthening system-wide connections.
Care breaks down when services, providers and supports operate in isolation. For states seeking more targeted support, we offer focused care coordination as a standalone option, connecting providers, community resources and services without the full infrastructure of case management.
How We Help
- Align services across Medicaid, behavioral health and social supports
- Improve continuity of care across systems and transitions
- Strengthen communication across care teams and agencies
- Support HCBS, waiver and integrated care models
- Reduce fragmentation without adding provider burden
Selected Work
Recent engagements
Strengthening rural care coordination and system alignment
Through the Alaska Medicaid Coordinated Care Initiative, we provide in-person, one-on-one case management for members with high emergency room use, helping them navigate the health system and access the care they need.
Coordinating person-centered behavioral health care
Through the Oregon Behavioral Health Support Program, we connect adults with severe mental illness to resources and support coordinated, individualized care planning across providers and services.
Delivering tailored care and support for employer populations
For employers such as Northwest Plumbing and Pipefitting and Puget Sound Electrical Workers, we provide utilization review to help members get the right care at the right time.
How we work
Neutral convener
Trusted by agencies, providers and communities
Data-informed partner
Using evidence to guide decisions and identify patterns
Community-rooted collaborator
Grounded in local context and relationships
Clinically rigorous
Deep experience serving high-need populations
Scalable and adaptable
Able to support programs across settings and states
Related Practices
Often connects with these capabilities
Let's improve care for the people who need it most.
Looking to strengthen care management or improve outcomes for high-need populations?