For Case Managers

Clear eligibility, measurable outcomes, and simplified billing. Everything you need to determine when HealtheMed is the right service for your clients.

For Case Managers

We Reduce Your Burden. You Focus on Your Clients.

HealtheMed was built around the realities of your day. We know your caseload is large, your budget is tight, and approval processes can be slow. HealtheMed is designed to make eligibility clear, billing simple, and coordination seamless.

We provide daily engagement, proactive monitoring, and measurable outcomes that give you confidence a client is stable at home, without adding more paperwork to your plate.

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What We Deliver

Designed Around What Matters to You

Every part of the HealtheMed experience is built to address the priorities case managers deal with every day.

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Simplified Billing

Just two billing codes: S5165 and S5110/S5115.

No T2029, fewer budget tradeoffs, and easier planning for you.

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Clear Eligibility

A concise eligibility snapshot so you can quickly determine when HealtheMed is — or is not — a beneficial service for your client.

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Measurable Outcomes

Outcomes you can point to:

50% fewer ER visits
17% medication adherence improvement (relative to baseline at program onboarding)
40% hypertension improvement (clients improve at least one stage per AHA)

Complements Other Services

HealtheMed is designed to work alongside existing waiver services, not replace them. We fill the gaps between visits and support long-term stability at home.

Proven Results

Outcomes That Support Your Decisions

Referral and approval decisions often hinge on whether a client can remain stable, supported, and independent at home. These are the outcomes we see in our clients.

80%

Appointment Completion

17%

Medication Adherence Improvement
Relative to baseline at program onboarding

40%

Hypertension Improvement
Clients improve at least one stage per AHA

50%

Fewer ER Visits

Enrollment Guidelines

Is Your Client Eligible for HealtheMed?

HealtheMed is often the most beneficial for clients who have two or more of the following:

Chronic diagnoses
Limited mobility or functional limitations impacting independence
Frequent ER visits or hospitalizations in the last 12 months
Desire to live independently in their community
Need for ongoing health and wellness support
Barriers to accessing regular doctor or mental health visits

If you are ever unsure, we welcome your questions and are happy to consult before a referral is submitted.

Waivers We Serve

Available Across All Waivers

HealtheMed is approved for clients on traditional waivers and CDCS across 35+ Minnesota counties and growing.

CADIDDBIEWCACAC

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Service Clarity

How HealtheMed and Skilled Nursing Work Together

HealtheMed nurse consultants are not a substitute for skilled home health nursing. Each serves a distinct purpose. The comparison below highlights how the roles complement one another.

Dimension	HealtheMed Clinical Nurse Consultant	Skilled Home Health Nurse
Primary Purpose	Long-term stability, prevention, and independence at home	Direct treatment and stabilization of acute medical needs
Start of Service	Ongoing chronic needs, risk of decline, support for independent living	New diagnosis, acute change, or post-hospital order
Care Model	Telehealth, remote monitoring, and periodic home visits	In-person, hands-on care ordered by a provider
What They Do	Preventive monitoring and education for chronic conditions; vital sign and medication adherence monitoring; early identification of health changes; SDOH assessments; care collaboration	Hands-on skilled nursing (wounds, injections, IVs, catheters); assessment of acute changes; limited, episodic education
Skilled Procedures	No	Yes
Engagement	Vitals monitored up to 5 days/week; monthly check-ins minimum; quarterly visits or as needed	1–7 days/week as medically necessary
Duration	Ongoing	Time-limited based on medical need
Client Focus	Chronic condition management, prevention, avoiding unnecessary ER visits	Acute treatment and stabilization

Streamlined Billing

Simplified Billing Codes

A streamlined two-code billing structure is designed to reduce budget tradeoffs and make planning straightforward.

S5165 — Environmental Accessibility Adaptation

Technology Platform: Includes approved monitoring platforms, remote patient monitoring, and medication adherence tools. Covers assessments, equipment rental, installation, training, and maintenance.

S5110 / S5115 — Home Training

Per 15-minute increments: Client and/or caregiver training provided in-home and remotely by health navigators, nurses, engagement specialists, and technology support.

Getting Started

How to Make a Referral

Making a referral to HealtheMed is quick and straightforward.

Review Eligibility

Confirm client is on a waiver (traditional or CDCS). Review current medical supports and, if eligibility criteria apply, talk to your client about potentially adding HealtheMed.

Submit the Referral

Submit via phone or at healthemed.com/refer with client consent. Our team will follow up to coordinate next steps.

We Begin Support

HealtheMed works alongside the existing care team to begin engagement and support. You receive periodic updates on your client's progress.

Ready to Refer a Client?

Fewer crises for you, better outcomes for your clients. Start a referral or connect with our team to learn more.

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