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Support to Navigate Challenging Health Conditions
Stanford Coordinated Care Program (SCCP) is a Stanford Medicine primary care referral-based program. As a team of medical professionals, we help individuals with chronic/complex serious illnesses lead healthier lives and better navigate their health care experiences.. SCCP only accepts referrals from Stanford Medicine's primary care providers.
Palo Alto, CA 94304
Phone: 650-724-1800 Getting Here
Our Primary Care Doctors
Stanford Coordinated Care Program (SCCP) Is a Primary Care Program Whose Specialty Is the Treatment of Chronic or Complex Illness
At Stanford Coordinated Care Program (SCCP), our multidisciplinary team helps patients with chronic/complex medical conditions stabilize their health by enhancing their confidence and ability to manage their health so they can better live with their condition(s).
We utilize the Institute for Healthcare Improvement’s “Triple Aim” model to (a) improve patients' health, (b) enhance the patient experience of health care, while (c) managing or lowering the costs of medical care (for example, reduce hospitalizations and emergency room usage when possible).
Clinicians available to SCCP patients include:
- Primary care physician
- Patient care coordinator
- Behavioral health specialist (licensed clinical social worker)
- Nurse practitioner
- Clinical pharmacist
- Licensed occupational therapist
- Registered dietician
The Stanford Coordinated Care Program currently accepts direct referrals only from Stanford Medicine primary care providers. The patients we accept often struggle with persistent, serious health conditions such as (but not limited to) diabetes that is difficult to manage, heart disease, asthma/chronic lung conditions, autoimmune disorders, etc.
Yes, only the physicians and Coordinated Care team will know who is enrolled.
Each Stanford Coordinated Care patient has a care coordinator who is responsible to assist their panel of patients with their needs. Our highly trained and experienced care coordinators support SCCP patients by:
- Being the patient’s “point person” on their primary care team and communicating with the patient’s primary care provider, and other members of the SCCP care team, on the patient’s behalf;
- Identifying and planning with the patient, in achievable steps, how he or she can address and attain their individualized health goals;
- Keeping in touch with the patient between visits, by phone or MyHealth messages, to provide support or, at the patient’s request, check in regarding the patient’s progress on goals.
We accept new patients year-round.
Stanford Health Care is known worldwide for the advanced patient care provided by its doctors and staff. We also provide a wide range of guest services and amenities to our patients and visitors. Learn more about preparing for a hospital stay, billing and financial services, and our other support programs in Patients & Visitors.
Please call our primary care advice service line at 650-498-9000 before going to the emergency room, unless you feel that you cannot safely wait a few minutes to speak to us. Another option would be our Express Care clinic open 7 days/week from 9 a.m. – 9 p.m with in-person and video options.
We will make every effort to offer you an appointment the next day for urgent problems if the problem can safely wait until morning.
In major emergencies, call 911 for an ambulance or proceed directly to the nearest emergency room.
Call us to learn more
For Health Care Professionals
Monday – Friday, 8 a.m. – 5 p.m.
Stanford Health Care provides comprehensive services to refer and track patients, as well as the latest information and news for physicians and office staff. For help with all referral needs and questions, visit Referring Physicians.
You may also submit a web referral or complete a referral form and fax it to 650-320-9443 or email the Referral Center at ReferralCenter@stanfordhealthcare.org.
HOW TO REFER
- Send referrals online
- Place radiology orders
- View referral status
- Access medical records