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Saginaw Pathways to Better Health

How to Help Patients Access Services

Helping people live healthier lives, and lower the costs of health care.
Health care delivery can be complex, especially for patients with multiple chronic illnesses. Saginaw Pathways to Better Health assists individuals in accessing the social services they need and addressing challenges that might affect their health care. Saginaw Pathways works together with health care and social services providers and other resource organizations to align patients with the help they need to better achieve their health goals.

We can help your patients stay on the path to better health.
Saginaw Pathways to Better Health’s services are FREE to qualified patients and are accessed through the Saginaw Community Care HUB. Eligible patients are referred to local Pathways-affiliated Care Coordination Agencies who assign Community Health Workers to meet with patients in their homes. There, the Community Health Workers assess health care needs as well as other challenges that may affect their ability to get the care they need – such as transportation, child care, managing medications, and more – then connect patients with community resources that can help.

Community Health Workers help patients identify “pathways” that will help them understand and manage their health goals, and conduct monthly follow-up home visits to make sure patient needs are being met.

Community Health Workers are supervised by nurses and social workers.

Saginaw Pathways to Better Health care coordination agencies and partners include:
Care Coordination Agencies

  • Covenant HealthCare/Visiting Nurse Special Services
  • Health Delivery, Inc.
  • Saginaw County Department of Public Health
  • St. Mary’s of Michigan/Center of HOPE

Outreach Agency Partners

  • Mobile Medical Response, Inc.
  • 2-1-1 Northeast Michigan

Better choices, better health.
Saginaw Pathways to Better Health’s “person-centered” approach empowers people to help themselves by …

  • Coaching them to make better choices
  • Connecting them to resources to improve chronic medical conditions while addressing important social services needs
  • Building self-advocacy

Who qualifies for help from Saginaw Pathways to Better Health?
Our services are free for patients who …

  • Are 18 years and older
  • Have two or more chronic health conditions
  • Are eligible for or enrolled in Medicare and/or Medicaid or Healthy Michigan
  • Live in Saginaw, Bay, Midland or northern Genesee counties or the Thumb area

Help your patients help themselves.
To refer a patient to Saginaw Pathways to Better Health, email or call the Saginaw Community Care HUB at 989.498.2266. One of our HUB Enrollment Specialists will take your referral information and make the contact with your patient. Your patients can also contact us directly.


Info to Know
Community Health Workers: helping to optimize the health care experience
Community Health Workers (CHWs) extend the care of health care providers and hospitals into the community by helping patients to identify “pathways” that will help them better understand and manage their health goals. CHWs work directly with patients in their homes – assisting them with managing their medications, helping them adhere to recommended diet and exercise regimens, and discovering other unmet needs that may affect their health care – such as transportation, child care, or housing – and connecting them with community services that can help.Community Health Workers are supervised by nurses and social workers.The addition of CHWs to the health care team is seen as a key strategy to help achieve the Centers for Medicare and Medicaid Services (CMS) project goals of better care, better health, and lower costs.