- Proactive population identification processes
- Chronic disease care gaps identification
- Evidence-based national practice guidelines
- Collaborative practice models, including physicians and support-service providers in treatment planning for members
- Continuous patient self-management education, including primary prevention, coaching related to healthy behaviors and compliance/surveillance, and case/care management for high-risk members
- Process and outcomes measurement, evaluation and management
- Ongoing communication with primary and ancillary providers regarding patient status
Who is Eligible?
All Healthy Blue members with the following diagnoses are eligible for DM services:
- Bipolar disorder
- Coronary artery disease
- Congestive heart failure
- Chronic obstructive pulmonary disease
- Major depressive disorder, adult and child/adolescent
- Substance use disorder
Through continuous case finding efforts, welcome calls, claims mining and referrals, we identify members who are eligible for DM services. If you would like further information on any of our programs, please contact us.
Maximize Your Time
As a valued provider, you can refer your patients who could benefit from education or care management.
Get Help with Treatment Plans
In order to assist in managing patients, we request your input for patient treatment plans. We provide DM information and the most up-to-date Clinical Practice Guidelines
to help you create an individualized plan of care.
Receive Feedback on Patients
Providers can access Patient360 to obtain feedback on their members regarding their care plans and
condition management while enrolled in DM.