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Scott & White Health Plan

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ERS Disease Management 2010

State of Texas and Higher Education
Employees, Retirees, and their Dependents

 PY2010

Disease Management

Our disease management programs are interventions designed to address:

  • Condition Monitoring
  • Adherence to treatment plans set up by your physician and disease management care coach
  • Consideration of other health conditions you may have
  • Lifestyle issues
  • Informed decision making
  • Skill building and motivation for effective self care

Members who are identified for one of these programs will be contacted and given the option of participating in a program or opting out of the service.

The following are Disease or Condition Care Management Programs offered at no charge by the Scott & White Health Plan to Texas Employees Group Benefits Program.

  • Asthma
  • Chronic Back Pain
  • Chronic Kidney Disease
  • Chronic Obstructive Lung Disease (COPD)
  • Cognitive Impairment
  • Congestive Heart Failure
  • Coronary Artery Disease (CAD)
  • Crohn's Disease
  • Depression
  • Diabetes
  • Epilepsy/Seizures
    		•   
  • HIV/AIDS
  • Hypertension
  • Migraines
  • Multiple Sclerosis (MS)
  • Obesity
  • Osteoarthritis
  • Parkinson's Disease
  • Post Traumatic Stress
  • Rheumatoid Arthritis
  • Ulcerative Colitis

    • Participants are identified through:
  • Medical & RX claims data
  • Health risk assessments
  • Physician referrals
  • Self-referrals
  • Diagnosis
    		•     
  • Alternate levels of care
  • ER utilization
  • Lab/diagnostic data
  • Predictive modeling
    		•

    Members receive tools and support through:
  • Contact by registered nurses, behavioral health clinicians and their support personnel
  • Individualized support to member's physician's treatment plan
  • Family members with same condition have limited participation at no cost.
    		•

    The SWHP VitalCare Disease Management/Condition Management program is available 7 a.m. to 8 p.m. CST Monday through Friday and 8 am to 8 pm Saturday.  Emergency issues clinicians are available 24 hours a day, 7 days a week.

    If you have questions or concerns about any of these programs, please feel free to call the SWHP Customer Service number at (800) 321-7947 or the Health Services Division at (888) 316-7947 for assistance in speaking to the program representatives today.

     

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