Disease Management Programs
Disease Management Programs
Download a copy of SCHA's Disease Management Newsletter
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Disease Management (DM) is improving quality of life for individuals with common chronic disease conditions and reducing healthcare costs by preventing or minimizing the effects of a disease through integrative care.
Chronic diseases, such as heart failure, diabetes, asthma and many others affect millions of individuals and place a substantial burden on society through lost productivity and increased health care costs. DM empowers individuals, along with physicians and other care providers, to effectively manage these chronic diseases and prevent complications through adherence to medication regimens, regular monitoring of their health through physician visits, labs, standards of care, healthy diet, exercise and other lifestyle choices.
We obtain our members names through referrals from self/family, county staff, SCHA staff, data warehouse, medical or other providers, and we review claims based on diagnosis, pharmacy, hospitalizations, and ER visits. If one of our SCHA members is identified for one of our programs, they are automatically enrolled in the disease management program.
We currently have 3 programs: heart failure (ages 18-75), diabetes (18 and older), and asthma (kids ages 5-17 and adults 18-50). We also take referrals for children under the age of 18 for our diabetes program, for children under the age of 5 for our asthma program, and for adults with asthma over the age of 50. During the first 4 weeks after enrollment, we will engage members with a welcome letter, introducing ourselves and our program, followed by another letter and booklet of condition-specific information for that member. The final introduction step is a phone call to talk one-on-one with the member or parent/guardian of the member to find out how best we can help.
Our goal is to work together for the optimum health of our members. We also follow NCQA guidelines.