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Care Management Program Clinical Guidelines

Clinical Guidelines and Decision Support References

Updated: September 2021

Practitioner Program Description

One or more of your patients is participating in our care management program. As part of this program, your patients receive information and support services designed to help them improve and maintain their health through behavior and lifestyle changes. The programs are funded by employers or health plans and is available free of charge to eligible employees or health plan members and dependents, who are pregnant and/or have chronic disorders, such as heart failure, diabetes, depression, obesity, asthma or musculoskeletal pain.

The program is designed to complement your prescribed treatment plan and clinical decision-making. Our care managers encourage your patients to follow your recommendations. We advise patients to contact you about medical concerns and to call 911 or go to the ER in emergency situations. We will provide you with periodic reports on your patients' progress toward meeting program goals.

The major goal of this program is to help participants develop lifelong healthy habits and learn how to manage their conditions to reduce hospital visits and slow or reverse disease progression.

As a participant in the program, your patients will receive the following:

  • Periodic assessments to determine health status, educational needs and degree of condition control

  • Comprehensive condition-specific education based on clinical practice guideline recommendations

  • Education about general health, wellness and prevention as appropriate

  • Periodic follow-up calls to monitor progress toward meeting goals

  • Toll-free telephone access to a nurse, who can answer questions and offer support

    Evidence-based guidelines are used to support program interventions. You can view these guidelines by selecting the Clinical Guidelines and Decision Support References link on this site. The guidelines are based on the most current recommendations and updates published by organizations such as the American Diabetes Association (ADA), American Heart Association (AHA), American College of Cardiology (ACC), National Heart Lung and Blood Institute (NHLBI) and the Global Initiative for Chronic Obstructive Pulmonary Disease.

If you have questions or feedback about the program, please call the number provided in your introductory letter. We are pleased to offer this program to your patients to help them follow your treatment plan between visits and work toward health goals.

Finally, this site provides a copy of your practitioner rights. Please take a moment to review them.