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   1. CLINICAL GUIDELINES
   2.    ASTHMA
   3.    CONGESTIVE HEART
         FAILURE (CHF)
   4.    CHRONIC OBSTRUCTIVE
         PULMONARY DISEASE
         (COPD)
   5.    DIABETES
   6.    DEPRESSION

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Health Care Providers
Our disease management programs help members reduce the frequency and severity of chronic illness episodes by improving their health status and helping them manage their disease. Our programs are developed using nationally recognized evidence-based guidelines, which can be found on the menu bar.

Each disease management program has six components:

• Population identification processes
• Evidence-based practice guidelines
• Collaborative practice models that include physician and support-service providers
• Member self-care management education
• Process and outcomes measurement, evaluation and management
• Routine reporting/feedback loop (including communication with members, physicians, ancillary providers and provider profiling)

Members are identified as candidates for the disease management programs through a stratification process using predictive modeling. If a member is placed in the high-risk category, a disease manager will contact the member and complete an assessment to determine enrollment in the disease management program.

 

 

Financial Disclosure