Primary Care

Comprehensive Disease Management Program

Purpose: Empowering communities through proactive healthcare engagement, NovellaCare is a pioneering initiative that embodies the acronym CARE—Community Advocacy for Resilience and Empowerment. We’re dedicated to fostering healthier, more resilient communities by forging meaningful connections and offering tailored support for chronic disease management and primary care needs.

Description: NovellaCare is an innovative arm of the Hospital in Your Home model that places community well-being at the forefront. With a vision of reducing unnecessary hospital visits, readmissions, and improving overall community health, NovellaCare harnesses the power of engaged neighborhood health advocates—trusted members of the community who are passionate about empowering their peers.

Our Approach: At NovellaCare, we believe that healthcare starts with community. Our neighborhood health advocates, equipped with a deep understanding of the local context, facilitate face-to-face enrollment and build genuine relationships with individuals. Through ongoing community-based chronic disease management, we provide resources, education, and support to enable community members to take charge of their health journey.

Collaborative Care: For patients with existing primary care providers (PCPs), NovellaCare operates as an extension of their care team. We work closely with PCPs to ensure seamless coordination, holistic care, and improved health outcomes.

CARE in Action: Our acronym CARE—Community Advocacy for Resilience and Empowerment—captures our commitment to advocacy, empowerment, and fostering resilience within the community. We work collaboratively to ensure that every individual feels supported, informed, and equipped to make informed decisions about their health.

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Join us at NovellaCare, where we’re not just changing healthcare—we’re empowering communities to lead healthier, happier lives.