Case Study: Health Homes of Upstate New York (HHUNY) achieves fewer ED visits and better care coordination with Netsmart CareManager

HHUNY uses CareManager to coordinate care and improve health

Health Homes of Upstate New York (HHUNY) is a coalition of four regional organizations that coordinates care across 22 counties and 60 community-based agencies for Medicaid enrollees with chronic behavioral and physical health conditions. HHUNY faced the challenge of implementing the state’s health home model across behavioral, primary and acute care providers—managing care for up to 35,000 people—while exchanging authorized clinical information across multiple, disparate EHRs to improve outcomes and lower costs.

HHUNY implemented Netsmart’s CareManager to aggregate clinical data, connect multiple EHRs, facilitate authorized information exchange, track clinical quality measures, and manage authorizations and claims. Care coordinators use the platform to deliver whole‑person care (including housing, transportation and employment needs), and state data show the model is reducing emergency department visits and hospital stays, improving provider communication and making care management easier and more efficient.

HHUNY

Adele Gorges

Executive Director