How Your Health Plans Team Can Help Manage Your Chronic Condition
Not everyone is in tip-top shape. Many people suffer from things like asthma, diabetes, chronic obstructive pulmonary disease and heart issues.
Does that mean you can’t live an active and fulfilling life? Absolutely not. But it does mean that a certain amount of management and planning needs to occur.
Like many health insurance companies, Avera Health Plans offers personal health services to patients as a free benefit. Benefits like these are important considerations when choosing a plan.
Preston Renshaw, MD, Chief Medical Officer for Avera Health Plans, explains how case management works.
Why Use Case Management?
You may be thinking, if I have a doctor why do I need to connect with yet another person? Well, these member health advocates provide an array of services that can be helpful to members who don’t have an established primary care provider — and not everyone does.
But it can be helpful to anyone. Our nurse case managers collaborate with your primary care provider to ensure he or she has the full story of things that occur between checkups.
Successfully managing a chronic condition can cut down on long-term complications, which can improve your quality of life and save you money so you can enjoy it.
Services to Manage Chronic Conditions
Services include:
- Assistance finding preventive services and community and wellness resources
- Collaboration with your primary care provider
- Help to set up appointments and manage
- Prescriptions
- Creating care plans to successfully manage a chronic condition
- Help to manage multiple chronic conditions
Care Management in Action
- A person with asthma might get education about the importance of always taking preventive medications and carrying a rescue inhaler at all times — and creating a plan so you don’t forget it.
- Maybe you’re diabetic and are having problems saying “no” to all the goodies at work. Your disease manager can sit down and discuss ways of doing that based on your lifestyle to create a more likely plan for success.
Those small successes can make a difference over time for patients and even health systems. For example:
- Organizations partnering with Humana Medical Home Program, a fee-based care coordination program, decreased hospital inpatient admissions by 6%, according to the Patient-Centered Primary Care Collaborative.
- Those who participated in the program had a 15% decrease in health care costs vs. original fee-for-service Medicare.
Managing Multiple Conditions
So what does that all mean? What it comes down to is meeting the patient’s needs on all levels. These programs focus on the patient beyond necessary tests and screenings and look at the big picture of your overall well-being.
They can help make things a little less overwhelming if you’re managing multiple conditions or medications.
Case managers also are available via email and phone to answer everyday questions that might not warrant a doctor visit but may be just as important to your overall health.
Get Help Managing Your Care
- If you’re an Avera Health Plans member, log in to your member portal to learn more about this benefit.
- Call the case management team at 888-605-1331 to set up an appointment.
