Complete Care Stewardship
Whole-Person
Care Management
Better health starts with understanding the whole picture. Family Insight partners with health plans, hospitals, health systems, and healthcare providers to support members with complex medical, behavioral health, and social needs.
If you are seeking mental health services for yourself or a family member, explore Family Insight’s statewide Outpatient Therapy services available throughout Virginia.
Care built around real life.
Health is shaped by more than a diagnosis or a single appointment.
People with complex health needs are often navigating multiple providers, prescriptions, appointments, benefits, and community resources at the same time. Traditional healthcare can become fragmented quickly—especially when everyday barriers make it difficult to follow a care plan.
Family Insight works alongside healthcare partners to identify those barriers, connect members with the right resources, and coordinate across the people and organizations already involved in their care.
Rather than waiting for a missed appointment, worsening condition, or care transition to become a larger problem, our teams focus on earlier engagement, stronger connections, and practical support that helps members stay engaged in care.
Connecting the clinical and everyday factors that influence health.
Support is tailored to member needs and the structure of each healthcare partnership.
Proactive Engagement
Ongoing outreach and coordination designed to identify emerging needs, close care gaps, and address barriers before they contribute to a larger health crisis.
Care Coordination
Connecting care across primary care providers, specialists, behavioral health providers, hospitals, pharmacies, health plans, and community organizations.
Health-Related Social Needs Navigation
Identifying barriers such as transportation, food access, housing, utilities, benefits, and other social needs and connecting members with appropriate resources.
Behavioral Health Support
Helping members connect with behavioral health counseling, substance use services, and other resources when those needs influence overall health and stability.
Medication Support
Medication therapy management and support designed to improve understanding, adherence, safety, and continuity across providers and care settings.
Transitional Care
Supporting smoother transitions following hospitalization or another change in care through discharge support, medication coordination, follow-up planning, and connection to services.
Care Navigation
Helping members understand their care, available benefits, next steps, and where to turn for the services and support they need.
The right support takes more than one perspective.
Whole-person care works best when clinical care, behavioral health, and social support are connected—not operating in separate silos.
Family Insight brings together professionals from multiple disciplines who coordinate with a member's existing providers, health plan, and support network.
This allows us to serve as an extension of the healthcare team while keeping the member's needs at the center of the work.
Support based on the member—not a one-size-fits-all model.
There is no single path through healthcare. Some members need help connecting to one resource. Others are managing multiple chronic conditions, behavioral health concerns, medications, social barriers, and frequent transitions between care settings.
Complex Care Planning
For members with higher or more complex needs, care management can provide a consistent point of coordination across providers and services. Our teams identify barriers, organize priorities, close gaps in care, and help develop an individualized plan reflecting both clinical needs and everyday realities.
Community & Social Needs Support
Access to transportation, stable housing, food, benefits, behavioral healthcare, and community support can determine whether a member is able to follow through on a care plan. Our objective is not simply to make a referral, but to help create a clearer path from need to support.
Transitional Care
Hospital discharge and changes in care setting can be vulnerable points in a healthcare journey. Our teams coordinate with healthcare facilities, providers, pharmacies, and community resources to create stronger continuity and a clearer plan for what comes next.
Engagement is part of better care.
Even the best care plan cannot help if a member is unable to access it, understand it, or stay connected to it.
That is why engagement is an important part of Family Insight's model. We work to understand the barriers behind missed care, unmet needs, or difficulty navigating services—and then help create practical next steps.
By combining human connection with coordinated support, our teams can help healthcare partners reach members who may need more assistance navigating traditional systems of care.
Quality, coordination, and meaningful outcomes.
Value-based care shifts the focus from delivering more services to helping people achieve better health through higher-quality, better-coordinated care.
Family Insight supports healthcare partners by addressing many of the factors that contribute to fragmented care, poor engagement, and avoidable utilization.
By combining behavioral health expertise, care management, and social needs navigation, Family Insight can serve as an extension of the healthcare teams supporting complex populations.
Stronger member engagement
Improved care coordination
Closure of care and quality gaps
Better integration of behavioral and physical healthcare
Identification and navigation of health-related social needs
Improved continuity following hospitalization
Medication management and adherence support
Earlier identification of emerging needs
Appropriate healthcare utilization
Better access to in-network and community resources
Measurable quality and health outcomes
Extend care beyond the traditional clinical setting.
Family Insight works collaboratively with health plans, hospitals, health systems, and other healthcare organizations to support member engagement, improve coordination, address barriers to care, and connect clinical care with what is happening in a member's everyday life.
Individuals participating in these programs are identified or enrolled according to the eligibility and care management processes established through those partnerships.
We do not accept direct patient referrals into our Whole-Person Care Management program.
Discuss a PartnershipJulie Doyle
Director, Complete Care
julie.doyle@familyinsight.net (703) 659-0944