Care management improves health, saves money

A message from Bob Gluckman, M.D., Chief Medical Officer for Providence Health Plans

One of the best ways to improve the health of any population, and to make care more affordable for all, is to focus on helping people with chronic illnesses who require the most health resources.

With just 10 percent of people incurring 70 percent of health care costs, it only makes sense to see how well we can support those with conditions such as coronary artery disease, hypertension, asthma, diabetes, chronic obstructive pulmonary disease and congestive heart failure.

At Providence Health Plans, we believe that providing people with tools to better manage their overall health and help them take preventive measures will mean fewer complications and less time in the hospital or nursing home.

Providence's Care Management program last year worked with 30,577 people with more than 20 types of chronic conditions. Our care managers, all registered nurses, worked one-on-one with members (and with their primary care providers) to educate and empower them to take charge of their own health. We helped them understand which symptoms need immediate attention, how to better ask questions and communicate with their care providers, and the steps they could take to lower their health risks through lifestyle changes.

We encourage providers to refer patients to our care management team who might benefit from this program. Individuals also can refer themselves.

This program, which is voluntary for members, includes a comprehensive health assessment over the telephone with a care manager. The nurse and member develop a plan to address health and wellness goals. That might mean committing to a medication schedule for someone with hypertension, exercise or physical therapy for a heart disease patient, or making dietary changes for a person with diabetes.

The "secret sauce" in this program is the personal relationship between the member and the care manager. Our nurses are resource experts who help ensure regular and appropriate medical care and act as health coaches to help members to reach their health goals. The program is very popular, has won many awards – and it works. We track health outcomes to ensure that people have better treatment compliance, suffer fewer complications and avoid hospitalizations. For members who participate, satisfaction scores are 96 percent or better. And it's cost effective.

We are very proud of this program. Working together our care teams are reaching our goals to provide the best care experience, more affordable services and improved population health.

For more information, email or call 800-662-1121, or visit Providence Care Management.