The HealthQuest Heart Failure Disease Management Program has been designed to improve member health and support the continuous education of members and the providers who care for them. The HealthPlus Heart Failure Disease Management program is fully integrated to include disease management, utilization management, case management, behavioral health, and health and lifestyle activities. The HealthPlus programs incorporate interventions necessary to optimize patient care and are based upon up-to-date, evidence-based clinical practice guidelines that were developed and reviewed by physicians.
The objectives of the Heart Failure Disease Management Program are to:
- Slow disease progression
- Prevent heart failure after an acute myocardial infarction
- Reduce risk of member heart failure exacerbations and death
- Educate and empower members toward self-management of heart failure and co-morbidities
- Support members who have psychosocial issues and implement screening for depression when appropriate
- Educate and support health care practitioners through evidence-based medicine
- Encourage members to communicate with their health care practitioner about their chronic condition(s) and treatment regimen.
- Encourage and educate members about resources external to HealthPlus as appropriate
Information and decision support activities include:
- Condition monitoring (self-monitoring and medical testing)
- Foster member adherence to treatment plan and member education, which includes standards of care, medication adherence, and sick day plans.
- Management of co-morbid conditions
- Lifestyle issues (e.g., goal setting techniques, problem-solving, etc.)
- Community resource support
The HealthPlus HealthQuest Heart Failure Disease Management Program is available to eligible members in Commercial HMO/POS, PPO (Fully-Insured and Self-Funded), and Medicare Advantage.
Collaboration and Resources:
The heart failure disease management program has been structured to support the collaboration between HealthPlus and the Michigan Quality Improvement Consortium (MQIC). The MQIC guidelines are based upon several sources, including “Adults with Systolic Heart Failure” (January 2011) and the 2005 American College of Cardiology/American Heart Association Guideline Update (2009) for the Diagnosis and Management of Chronic Heart Failure in the Adult.
For more information about the HealthPlus HealthQuest Disease Management Program, contact a HealthPlus Disease Management Coordinator at (800) 345-9956, ext. 8050, or by e-mail at firstname.lastname@example.org.