ConditionCare
PW_AD037479
ConditionCare Programs offer an innovative approach to help members better self-manage serious chronic conditions such as Asthma and Diabetes, Chronic Obstructive Pulmonary Disease (COPD), Coronary Artery Disease (CAD), and Heart Failure.
Health professionals provide members with a variety of health education resources depending upon their health status and condition. The health professionals serve as a "health coach" motivating and encouraging members to adopt behaviors that lead to a healthier lifestyle.
Health Coaching - A Personalized Approach
The Health Coaching Model uses a team of health professionals such as registered nurses, respiratory therapists, behaviorists, dieticians and exercise physiologists to assist members in making difficult behavior changes to improve their health. These professionals coach the member through a personalized plan that promotes improved participation in an effort to complement a physician's prescribed treatment, not replace it. Depending on the member's condition, health coaches will provide health education in several forms including:
 | Telephone calls |
| On-line support |
| Educational mailings |
An assigned health coach works with a team of health professionals and the member to identify barriers, establish goals and identify a plan that will promote lasting health behavior change over time. The personalized plan is adjusted as needed to best address the changing needs of the member and to encourage better self-management of their chronic condition. Each member of the health coach team is trained to maintain the security and confidentiality of every participant.
ConditionCare Programs emphasize:
| Adherence to physician instructions and prescription orders |
| Understanding the disease process |
| Positive behaviors for lifestyle changes in diet, nutrition and exercise |
| Elimination of unhealthy behaviors such as smoking |
The result is a more empowered, confident member who is ready to tackle the more difficult behavioral changes and reach their health and lifestyle goals.
Enrollment
ConditionCare Program enrollment is voluntary and participation does not affect health benefits in any way. Because these programs have been shown to be beneficial and effective, member participation is encouraged.
Eligible participants are identified and referred to ConditionCare Programs in a number of ways:
| The plan's medical claims system |
| Hospital discharge reports |
| Physician or medical group referral |
| The plan's case management team |
Blue Cross Blue Shield of Georgia members may also self-enroll by calling (800) 638-4754.
Enrolled members may receive education materials through the mail or may be contacted by a health coach, a registered nurse, for an initial assessment. The assigned health coach and team of health professionals such as registered nurses, respiratory therapists, behaviorists, dieticians and exercise physiologists assist the member in making difficult behavior changes to improve their health. The health coach works with the member to identify barriers, establish goals and identify a plan that will promote lasting health behavior change over time. The personalized plan is adjusted as needed to best address the changing needs of the member and to encourage better self-management of their chronic condition.
Confidentiality
We take great care to ensure that all health information is kept confidential. The department follows company policies and procedures for confidentiality governing the handling of claims data and personal health information. Our company policies meet or exceed federal and state laws, regulations and accreditation standards. HIPAA Privacy Notice Participation in ConditionCare Programs is based on eligibility. Please contact us at (800) 638-4754 for questions regarding eligibility.
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