Avera Health Plans Disease Management
- Physician Directed
- Health Coach Supported
- Patient Empowered
Avera Health Plans' Disease Management and Health Coaching Programs reach out to members diagnosed with select chronic disease conditions. Members eligible for disease management are identified using a combination of methods and referrals and my also self-enroll. Incentive-based models may be used to encourage participation. Our certified health coaches maintain a 75-percent goal-attainment rate.
Disease Management Programs include:
Health Coaching Programs include:
Avera Health Plans' Disease Management and Health Coaching Programs are available to all fully-insured members and may be purchased by self-insured groups. To learn more about Avera Health Plans' Disease Management and Health Coaching Programs, please contact the Avera Health Plans Marketing Department.
Asthma Disease Management
Overview
The Asthma Program uses high-intensity interventions to improve the health of Avera Health Plans members diagnosed with asthma who are at high risk for adverse outcomes.
The Asthma Program utilizes health coaches to educate and support members to follow their doctor’s plan of care. Members participate in health coaching sessions by telephone. The frequency of the health coach/member interaction is dependent upon the severity of the member’s condition and their willingness to change. Members are provided educational materials and resources in a variety of media.
Disease Management activities are built on evidence-based, scientifically validated principles and nationally recognized standards.
Program Goals
Through quality education and support, we strive to increase medication compliance, promote use of an asthma action plan and peak-flow monitoring, decrease emergency room visits and inpatient hospital admissions and improve the health and lives of our members.
Participant Identification
The Asthma Program is available to most Avera Health Plans members, both children and adults, who have been diagnosed with asthma or reactive airway disease. Potential members are identified using a combination of Predictive Modeling, Health Risk Assessments (HRA) and assessment of readiness to change. We also encourage and welcome health care provider referrals into the program.
Diabetes Disease Management
Overview
The Diabetes Program uses high-intensity interventions to improve the health of Avera Health Plans members diagnosed with diabetes who are at high risk for adverse outcomes.
The Diabetes Program utilizes health coaches to educate and support members to follow their doctor’s plan of care. Members participate in health coaching sessions by telephone. The frequency of the health coach/member interaction is dependent upon the severity of the member’s condition and their willingness to change. Members are provided educational materials and resources in a variety of media.
Disease Management activities are built on evidence-based, scientifically validated principles and nationally recognized standards.
Program Goals
Through quality education and support, we strive to increase treatment plan compliance, increase blood sugar control and preventive screenings for complications, decrease emergency room visits and inpatient hospital admissions and improve the health and lives of our members.
Participant Identification
The Diabetes Program is available to both children and adults, who have been diagnosed with diabetes. Potential members are identified using a combination of Predictive Modeling, Health Risk Assessments (HRA), and assessment of readiness to change. We also encourage and welcome health care provider referrals into the program.
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Healthy Heart Disease Management
Overview
The Healthy Heart Program uses high-intensity interventions to improve the health of Avera Health Plans members diagnosed with coronary artery disease or cardiovascular risk factors who are at high risk for adverse outcomes.
The Healthy Heart Program utilizes health coaches to educate and support members to follow their doctor’s plan of care. Members participate in health coaching sessions by telephone. The frequency of the health coach/member interaction is dependent upon the severity of the member’s condition and willingness to change. Members are provided educational materials and resources in a variety of media.
Disease Management activities are built on evidence-based, scientifically validated principles and nationally recognized standards.
Program Goals
Through quality education and support, we strive to increase medication compliance, promote use of a chest pain action plan, decrease emergency room visits and inpatient hospital admissions and improve the health and lives of our members.
Participant Identification
The Healthy Heart Program is available to most adult Avera Health Plans members 35 years of age and older. Potential Members are identified using a combination of Predictive Modeling, Health Risk Assessments (HRA) and assessment of readiness to change. We also encourage and welcome health care provider referrals into the program.
Healthy Living Program
Overview
The Healthy Living Program provides interventions to improve the health of Avera Health Plans members who are overweight or obese.
The Healthy Living Program utilizes specially trained health coaches to educate and support members in making healthy lifestyle choices in an effort to lose weight. Members participate in health coaching sessions by telephone and may communicate with their health coach via e-mail or postal mail. The frequency of health coach/member interaction is dependent upon the member’s co-morbities, recommended weight loss and their readiness to change. Members are provided support resources and educational materials in a variety of media.
Healthy Living Program activities are built on evidence-based, scientifically validated principles and nationally recognized standards, including but not limited to, Institute for Clinical Systems Improvement (ICSI), National Heart Lung Blood Institute (NHLBI) and American Medical Association (AMA).
Program Goals
Through support, goal-setting activities and education, we strive to assist members in adopting healthy lifestyle changes, incorporating physical exercise into their lives a minimum of 2-3 times per week and losing weight.
Program Participation
The Healthy Living Program is available to most Avera Health Plans members. Members self-enroll in the program. We also encourage and welcome health care provider referrals into the program.
Hey Baby! Maternity Program
Overview
Avera Health Plans' Hey Baby! Maternity Care Program provides high-intensity interventions to support Avera Health Plans members who are at increased risk for adverse outcomes during pregnancy. In addition, the Hey Baby! Program provides a screening intervention to determine risk as well as support and educational materials to those Avera Health Plans members with healthy pregnancies and low risk of adverse outcomes.
The Hey Baby! Program provides targeted interventions aimed at increasing the enrollee’s knowledge about pregnancy, risk factors, signs of pre-term labor and complications. The Program supports members by providing them with customized information focused on self-management skills and building a support network.
Program activities are built on evidence-based, scientifically validated principles and nationally recognized standards.
Program Participation
The Hey Baby! Program is available to most pregnant Avera Health Plans members. Members self-enroll in the program. We also encourage and welcome health care provider referrals into the program.
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