Here For You: Our Diabetes and Congestive Heart Failure Programs

Diabetes and congestive heart failure are prevalent, chronic conditions that can impact many other areas of well-being. Our Case Management team strives to engage in ongoing diabetes and congestive heart failure care services so that our members can be equipped and empowered to live healthier lives.

Diabetes management programs

Currently, our case managers are enrolling members into two programs that are focused on diabetes management.  

The first is our Chronic Condition Improvement Program for Type 2 Diabetes. This program is designed to meet the needs of members who have been newly diagnosed with diabetes and to provide members with education and resources that will help them manage their new diagnosis. This program helps members understand how their new diagnosis can be managed effectively with proper medication management, diet and exercise.

The second is our Disease Management program designed to meet the needs of members who are having trouble effectively managing their diabetes and have higher A1Cs.

How enrollment works

Case Management works with our Quality department to determine which members would benefit most from these two programs. Once these members are identified, Case Management will reach out to the identified members to explain the program and offer enrollment. Case managers can also identify members through their daily interactions. Additionally, if a member is newly diagnosed with diabetes or is struggling to control their blood sugar, they can reach Case Management directly for enrollment.

Additional support for chronic conditions

Case Management also offers a virtual monitoring program for members with Congestive Heart Failure called CHF Home Care Connect to help members manage their condition at home through round the clock access to a virtual care team and easy to use monitoring equipment. Members receive tools to track vital signs, connect with specially trained nurses when symptoms arise and access educational resources, allowing the care team to closely monitor health and intervene early. The program is provided at no cost to eligible members and is designed to support better outcomes, reduce avoidable hospital visits and give both patients and providers greater peace of mind.

Get started with case management

If a member has a chronic condition and they would like more information or guidance, they can be enrolled into the Complex Case Management program with a care plan that focuses on their unique needs.

For more information about Case Management services, please contact 800-240-3870, option 5. They can be reached Monday through Friday, from 8 a.m. to 4:30 p.m., EST.