Provider-Delivered Care Management

PCMH-designated practices provide personalized care management services for patients with chronic conditions or multiple, ongoing health needs.

This integrated approach complements Blue Health and Wellness, which offers outreach and nurse coaching by phone.

Patient care teams are assembled according to each patient’s needs, and may include nurses, nutritionists, counselors, psychologists, respiratory therapists, asthma educators, certified diabetes educators, social workers, pharmacists and community health workers. Because the care team works in the Patient-Centered Medical Home, services are coordinated with the care the patient is already receiving from the doctor.

An analysis between a treatment group and a comparison group showed the treatment group had fewer emergency visits, fewer inpatient stays and lower medical costs. A recent internal analysis found that companies realized a 4% savings, equating to between $17 to $23 per member per month on patients engaged with the program.

Some specialty practices may deliver care management services to their patients. For more information contact Or, click here for information on reimbursement structure.