Disease Management Program

The Alere Disease Management program assists individuals with chronic diseases to better manage their conditions by increasing their knowledge about their illnesses, potential complications and importance of medication and treatment plan compliance.

Our highly-trained clinicians proactively contact participants to monitor their progress and ensure they are following the plan of care set by their physician. They work with participants to identify potential gaps in care, which occur when individuals do not receive national standards of care, or best practices, or when an individual fails to comply with their treatment plan.

Clinicians rely on the Health and Productivity Assessment, information gathered about program participants and telephonic interactions to help participants make better healthcare decisions.

Our programs are designed to:

• Increase compliance with the doctor’s plan of care and prescribed medications
• Reduce preventable utilization of healthcare services and prescription errors
• Improve the participant’s quality of life and workplace productivity
• Ensure appropriate testing in accordance with national clinical standards
• Improve care coordination
• Provide a support system of nurses, dietitians, pharmacists and educators who help participants proactively manage their condition and avoid potential complications that lead to major medical expenses

Whether the participant needs to have a test done, lose weight or comply with their prescribed medications, our clinicians attempt to close whatever gaps they identify through coaching, education, behavior changes, goal setting and, ultimately, patient empowerment.

Why Alere?

Differentiators include:

• Proven healthcare cost savings
• Leading technology, security and accreditation
• Robust identification and referral process for early outreach
• Specialized clinicians
• Evidence-based interventions
• Primary nurse or get-next nurse models
• Industry leading measurement and reporting

Features

Key features of the program include:

• Use the nursing staff to educate, support and monitor participants
• Experienced clinical team of nurses and experts from multiple disciplines, including registered dieticians, licensed practical nurses, pharmacists, exercise physiologists, respiratory therapists and medical directors
• Use of goal-setting and evidence-based methodologies to motivate participants to change behaviors
• Management of co-morbidities
• Integrated reporting that allows for effective tracking of utilization, data and cost trends

Benefits

For employers:

• Positive impact on absenteeism, presenteeism and overall productivity
• Demonstrated cost reductions while improving clinical, quality and financial outcomes
• Innovative Web reporting tools to effectively track utilization, data and cost trends
• Increased participant satisfaction through availability and utilization of program
• Private-labeled or co-branded programs that ensure messages are in sync with the employer’s corporate approach, philosophy and mission

For health plans:

• Improved quality of care through participant education and coordination of care
• Demonstrated cost reductions while improving clinical, quality and financial outcomes
• Increased provider and participant satisfaction through availability and utilization of program
• Innovative Web reporting tools to effectively track utilization, data and cost trends
• Private labeled or co-branded programs that ensure messages are in sync with the health plan’s approach, philosophy and mission
• Provision of multiple, integrated services through a single-source provider at a reasonable cost

For participants:

• Personalized support and education
• Customized interventions to meet individual needs
• Coordination of services among physicians
• Adherence to clinical treatment guidelines and patient safety protocols
• Guidance provided to navigate health system

For physicians:

• Care manager works directly with participant to reinforce physician’s plan of care
• Care manager supports care coordination with the physician by educating the participant about their care, identifying signs and symptoms of complications and facilitating prompt interventions as indicated
• Health updates are shared with the physician and care team when there are concerns or changes identified during telephonic assessments with the participant between office visits

How the Program Works

The Care Solutions disease management programs include a comprehensive clinical assessment supported by telephonic and online health improvement tools that guide participants to the most appropriate health practices. Using acknowledgement, reinforcement and encouragement, the programs are designed to:

• Increase participant knowledge
• Change lifestyle behaviors
• Improve quality of life
• Educate on preventive measures
• Provide a support system of nurses, dieticians, pharmacists and educators
• Increase participant engagement in the programs
• Lower client costs

Key elements of each program include:

Identification and stratification process. Eligible members are identified through multiple channel sources, such as medical, pharmacy and lab claims, wellness assessment, nurse line program, self-referrals, physician and ancillary provider referrals and biometric devices. After they are identified, they are stratified based on the severity and progression of their illness.

Enrollment and engagement strategy. During implementation, our consultants collaborate with you to develop a strategy to create awareness of our programs and inspire interest in participating.

Program touch points. Our program encompasses critical touch points during the program targeted to participants and physicians.

Clinical care team. All clinicians are subject to a thorough initial credentialing process and to regular evaluations thereafter. Clinical staff also receive extensive, ongoing training in the specifics of each disease state, current treatments and behavior modification and educational strategies.

Program measurement. Alere provides innovative tools and guidelines to measure the performance and success of the program.

Client implementation support. We provide a dedicated team led by an experienced implementation manager comprising representatives from clinical services, IT and data services, contracting, finance, marketing and health information staff.

Our programs are ideal examples of how the potent combination of information and clinical expertise can enable participants to become more knowledgeable about their health and provide support for them as they make the necessary changes to measurably improve their lives.

For more information about the program, email Sales.