METS (Members Empowered to Succeed)
Date: 04/25/24
METS takes a unique approach to member care. We partner with the provider and member to ensure that the member achieves the ultimate level of recovery and resiliency. Our Clinical Liaisons work directly with providers to identify the member’s treatment and support needed for successful progress in treatment. The Clinical Liaison assists with coordination of care when multiple providers are involved to provide cohesive communication. Additionally, our Service Coordinators assist with identification of resources to meet the member’s behavioral health, social, and medical needs. Focusing on the member’s individualized needs creates a recovery roadmap that is as unique as the individual member.
BENEFITS & OUTCOMES OF METS
- Integrated, whole health approach to member’s needs and care including behavioral health, medical, therapeutic, pharmacy, and supplemental
- Dedicated team of specially trained Behavioral Health Clinical Liaisons and Service Coordinators, alleviating additional lift for providers
- Identification of outpatient high utilizer trends to pinpoint members who could benefit from the program
- Cross-care team partnership to ensure coordination of care and collaborative problem solving
- Coordination of services and treatment between multiple providers
- Reduction in administrative tasks with increased resources for care coordination
- Knowledge of covered services, such as expanded benefits or new programs and how to access
- Arrangement of reminders and assistance with accountability for delivery of treatment/discharge plans
THE METS TEAM
METS Clinical Liaisons:
- Have knowledge related to the member’s health plan processes and programs that can assist you as the provider in the utilization management process
- Are licensed clinicians who have both clinical and UM experience within managed care
- Review the member’s treatment records and collaborate with the provider for additional clinical information and support
- Develop a care strategy that best matches the member’s needs to the lowest acuity setting, taking into account the member’s goals and desired outcomes with an emphasis on delivering high-quality care
METS Service Coordinators:
- Have knowledge related to the member’s health plan processes and programs that can assist you as the provider in accessing covered and available services
- Are skilled in motivational interviewing and identifying resource needs, and will provide additional support to your members
- Partner with the Clinical Liaison and member to make sure that the treatment aligns with the member’s personal goals, taking into account social determinants of health, health literacy, and availability of community resources