Disease Management
Improving health outcomes through education and evidence-based guidelines
American Health’s URAC-accredited Disease
Management program targets nine prevalent conditions for which evidenced-based guidelines are established to impact health and measure improvements:
- Asthma
- Chronic kidney disease (CKD)
- Chronic pain (osteoarthritis, rheumatoid arthritis or low back pain)
- Coronary artery disease (CAD)
- Congestive heart failure (CHF)
- Chronic obstructive pulmonary disease (COPD)
- Diabetes
- Hyperlipidemia
- Hypertension
Members with chronic conditions are identified through an advanced predictive modeling system and, once enrolled, work one-to-one with a dedicated nurse health coach. All of American Health’s Disease Management nurse coaches are registered nurses who have been trained in motivational interviewing techniques.
Nurse health coaches identify participants’ confidence and ability to self-manage their condition using the Patient Activation Measure® assessment, developed by Insignia Health. They then help participants set individualized goals using Insignia’s Coaching for Activation® behavioral change model.
Transitional Disease Management
When historical claims data is not available, we offer Transitional Disease Management to support clients during year one. Participation in the program is achieved through self-referrals, and American Health’s team will assist clients with communication and strategic plan design to drive engagement in the program. Members will engage with nurse health coaches as described above in the Disease Management program. Transitional Disease Management does not include predictive modeling or member outreach. Beginning in year two, groups can transition to Disease Management with the submission of the required historical claims data.
See our Disease Management key statistics
Read Evelyn's story and others on our case studies page
See what our members have to say about Disease Management
Product Highlights
- Nurse health coaches use motivational interviewing techniques to empower individuals to self-manage their conditions
- Our wellness and disease management consultant assists in developing a plan for optimal program engagement
- Cost-savings methodology accredited by third party, SCIO Health Analytics
