Take a holistic approach to managing the care of your health plan members

Look at the whole person, not just the disease

Health plans are beginning to take a holistic approach to managing patient care, focusing on the member's overall health instead of just one condition or episode of care.

They're combining previously separate disease management, case management, and health coaching efforts into one program, assigning a care manager who provides continuity of care and works with the member no matter what his or her needs.

"Rather than just looking at the symptoms or the member's immediate needs, we look at the entire individual and all his or her health care needs across the continuum of care. We offer whatever interventions our members need, from wellness to illness and back to wellness," says Steven Goldberg, PhD, director of case management/utilization management for Regence BlueCross and BlueShield of Oregon.

In this issue of Case Management Advisor, we'll tell you about three programs that provide holistic care for three very different member populations.

We'll show you how Philadelphia-based Keystone Mercy Health Plan saved $6.1 million in the first year with its highly successful PerforMED program, which provides case management, disease management, and behavioral health coordination for publicly insured members.

You'll learn how the care advocates at Regence BlueCross and Blue Shield of Oregon provide whatever the member needs, whether it's help with smoking cessation, care management through an acute illness, or working with members to get their chronic conditions under control.

And we'll give you details on the case management program at Crescent PPO in Asheville, NC, where case managers conduct wellness education and make home visits as they coordinate the care for self-insured employer groups.