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Case/Disease Management

US Family Health Plan members with complex medical needs are now able to receive special care designed to help them understand and manage their conditions.

Diabetes, heart failure, asthma and cancer and other chronic diseases often require more patient education and ongoing support than a provider can offer. That’s why our highly trained nurse case managers stand ready to help patients by coordinating care, serving as personal advocates and providing ongoing support to help patients learn to care for themselves and monitor their own health.

Nurse case managers can help with:

• Scheduling doctor appointments and obtaining referrals
• Coordinating specialty care
• Obtaining medical equipment and supplies
• Providing health education
• Understanding and using USFHP benefits

All of our Case/Disease Management programs are voluntary and specially created to meet the need of each individual member. Case managers visit members at home, in the hospital and sometimes accompany members to the provider in order to learn about and support the provider’s plan of care. The relationship formed between the member and the case manager is often long lasting and includes family members and other support systems.

The following programs are available to USHP members:

• Partners with Mom - for mothers experiencing a high risk pregnancy
  
• Children with Special Needs – children with medical problems such as diabetes, complications of prematurity, congenital problems, sickle cell, obesity, neurological problems or genetic syndromes
  
• NICU – for babies in the Neonatal Intensive Care Unit
  
• ESRD (End Stage Renal Disease) - for members on dialysis to treat severe kidney disease
  
• Complex Medical – for members having special needs or complex chronic conditions such as asthma, COPD, diabetes, high blood pressure, morbid obesity
  
• Telemedicine – for members with heart failure, or diabetes with coronary artery disease, peripheral vascular disease, diabetic retinopathy or hypertension
  
• Rehabilitation – for adult members with rehabilitation needs such as spinal cord injury, traumatic brain injury, severe burns, or a motor vehicle accident
  
• Omega Life – for members who have received a cancer diagnosis
  
• HIV/AIDS

USFHP members can be evaluated for the program by the Care Management staff at enrollment, during hospital admissions, upon receiving complex in-home care, when health claims indicate a special need, or when the member requests case management.

Information:

*Please do not send any Protected Health Information (PHI) and personal medical information when using the E-mail link bellow. Please include contact information in case we need to reach you.

For more information on any of the case/disease management programs please call 1-800- 557-6916 or e-mail at casemanagement@jhhc.com