A structured, end-to-end approach to aligning with your practice, identifying eligible populations, and delivering continuous longitudinal care.
1
Practice AlignmentBloomCare meets with the provider group to understand patient populations, workflows, diagnoses, payer mix, program goals, escalation preferences, and operational needs.→
2
Patient IdentificationEligible patients are identified for CCM, RPM, BHI, TCM, add-on support programs, caregiver support, and specialty pathways.→
3
Patient Outreach & EnrollmentBloomCare contacts patients and caregivers to explain BloomCare, confirm interest, answer questions, review services, and support enrollment.→
4
RN AssessmentEach patient receives a thorough onboarding assessment covering diagnoses, medications, symptoms, risk factors, barriers, SDOH needs, goals, caregiver involvement, and care preferences.→
5
Individualized Care PlanBloomCare creates and maintains a detailed individualized care plan unique to each patient's condition, risk level, goals, and support needs.→
6
Monthly Support & MonitoringPatients receive recurring RN-led engagement, education, care plan reinforcement, medication support, symptom tracking, resource connection, and escalation support.→
7
Escalation & Provider CoordinationWhen a patient has concerning symptoms or same-day needs, BloomCare RNs escalate to the practice and can coordinate with designated on-demand providers on behalf of the practice when immediate attention is required.→
8
Reporting & OptimizationBloomCare provides visibility into enrollment, engagement, risk, escalation activity, patient needs, and program performance.