Chronic Care Management

Chronic care management support that improves health and lowers costs

According to the Centers for Disease Control and Prevention (CDC), chronic diseases such as cardiovascular disease, chronic obstructive pulmonary disease (COPD), diabetes, hypertension, and asthma, affect nearly half of US adults and account for 84% of all healthcare costs. Health Dialog’s Chronic Care Management solution addresses the problem with an NCQA-accredited Disease Management program that provides personalized interventions to help individuals better manage chronic diseases and reduce costs. Programs range from a basic disease management service that meets your NCQA requirement to a more comprehensive total population health management solution. Health Dialog has years of experience implementing care management programs that get results.

Components of the chronic care management program can include:

  • NCQA accreditation for 5 major chronic diseases and support for over 65 co-morbid and preference sensitive conditions
  • Powerful analytics to stratify your population based on key risk indicators
  • Multi-channel engagement campaigns via telephone, mail, email, text, web chat, or interactive voice recognition outreach
  • Outbound telephonic whole-person health coaching focused on reducing gaps
  • 24/7 inbound telephonic access to our Health Coaches for urgent, acute, and self care needs
  • Post-hospital discharge outreach to help avoid unnecessary readmissions
  • Shared decision making tools on preference-sensitive and chronic conditions to educate and guide members on treatment choices and condition management
  • Health education tools, including online and print materials and an audio reference library
  • Comprehensive reporting on clinical and financial outcomes, patient satisfaction, and operational metrics

Key Features and Benefits:

  • 24/7/365 immediate access to nurses, not a callback system
  • HDC3™ platform—Used by our nurses, this sophisticated coaching workflow tool captures patient details, health plan information and resources, and clinical support tools to guide patient interactions and create a seamless integration with the health plan or provider.
  • LanguageLine live interpretation services in more than 200 languages
  • Healthwise® Knowledgebase and bilingual educational content

Add-On Solutions: