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2020 Population Health Management

March 27, 2020

Our 2020 Population Health Management programs help your BlueCross BlueShield patients manage acute or chronic illnesses to achieve better health outcomes. We review each patient’s case and plan benefits and connect them with one of our care managers who will help support your patient’s medical and psychosocial needs while reinforcing your care plan. You will be provided with updates on your patient when appropriate.

When you enroll a patient in Population Health Management, they receive:

  • Health care support from a registered nurse (health coach)
  • A care plan based on your recommended treatment
  • Assistance from a pharmacist, social worker, respiratory therapist, chiropractor, behavioral health specialist, and dietitian, as needed
  • Information and resources about their illness
  • Help coordinating services among their providers
  • Assistance in finding community services

Population Health programs include:

Asthma: Helps to improve the health status for patients with asthma using a multi-disciplinary, population-based approach and promote evidence-based treatment to help patients achieve better control

Behavioral Health: Provides education, assessment and screenings, referrals, and care coordination for patients with behavioral health conditions such as:

  • ADHD
  • Depression
  • Substance Use Disorder (SUD)

Care Management is available for members with any behavioral health diagnosis

Cardiovascular Health: Provides education and community resources to improve self-management for patients with cardiovascular disease

Chronic Kidney Disease: Helps patients coordinate care between nephrology and primary care, and provide education on disease progression

Diabetes: Helps patients with diabetes comply with regular testing and provides education on controlling A1c

Obstructive Sleep Apnea (OSA): Patients approved for a sleep study and/or newly diagnosed with OSA will be contacted by a respiratory therapist (RT), who will address concerns with C-PAP therapy, provide recommendations for lifestyle behavioral modifications and support existing comorbidities

Oncology: Promotes patient understanding of cancer care network and treatment options; connects patients with specialists and, when appropriate, assists in the transition to hospice/palliative care

Palliative care: Helps patients at the end-stage of a progressive illness manage symptoms, and provides comfort and assistance with advance directives

These programs focus on whole person health – addressing medical, behavioral, emotional, and economic needs. Through outreach and education, your patients get help implementing care plans and goals, and get behavioral health and social services support through community partnerships.

If you feel that your patients would benefit from Population Health Management services, please call us at 1‑877‑878‑8785, option 2.

For a full list of available programs and their descriptions visit:

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