UM Upper Chesapeake Health is proud to be a Care Transformation Organization (CTO). Our care transformation teams partner with many primary care offices in Harford County. We are committed to helping these providers care for their patients who have complicated health issues.  The goal is to reduce the need for stressful hospitalization while improving quality of life with better health outcomes and patient satisfaction.

Benefits for Your Patient

When you select UM Upper Chesapeake Health as your Care Transformation Organization, you will get a team of experienced professionals including care managers, pharmacists and community health and social workers, and access to a variety of other resources. Care continuity for your patients—from emergency department visits to hospital discharges—is available to all members of the CTO based on how strongly we communicate and share information. 

CTO Team Roles

Registered Nurse Care Managers

  • Medication, lab and hospital discharge follow-up
  • Chronic disease education
  • Support in establishing home health care and durable medical equipment needs
  • In-person appointments for education and medication reconciliation
  • Telephone case management for rising risk
  • Care coordination to include pre-visit planning, appointment scheduling and referrals within the CTO


  • Comprehensive medication review and consultations during doctor appointments
  • Medication organization and education

Community Health Workers

  • Assistance with program applications (ie: Medicare savings programs)
  • Connection to food access, transportation and housing resources
  • Support during Medicare open enrollment 
  • Connection to county agencies and VA benefits, if appropriate

Social Workers

  • Available to participate in family meetings around overall goals of care, including long-term planning
  • Assistance with advance directive and power of attorney documents
  • Mental health community connections

Our team works together to support your practice as you strive toward transforming your delivery of care to your most complex patients. 

Contact Information

Michelle Brusio, MSN, RN, CCM
Clinical Manager, Population Health, CTO and Primary Care or 443-643-5045