Anthem Condition Care is a comprehensive program designed to provide coordinated care management and support for individuals managing chronic health conditions. Our primary mission is to enhance the health and overall quality of life for our members by actively promoting self-care, delivering crucial healthcare education, and offering targeted interventions throughout their care journey. We understand the complexities of living with chronic illnesses, and our program is built to be a guiding resource, empowering both members and their healthcare providers.
Comprehensive Condition Care Services
Our Condition Care program adopts a holistic, member-centric approach. We prioritize the unique needs of each individual, offering support through both telephonic consultations and community-based resources. This ensures accessible and personalized care, wherever our members are. Key services include:
- Member-Centric Holistic Approach: We move beyond just treating the condition, focusing on the whole person and their individual circumstances.
- Motivational Interviewing Techniques: Our trained professionals utilize motivational interviewing to empower members to take an active role in their health management and self-care. This approach fosters intrinsic motivation and long-term adherence to care plans.
- Multi-Disease Management: Recognizing that many individuals manage multiple chronic conditions, our program is expertly designed to address and coordinate care for more than one disease simultaneously. This integrated approach simplifies healthcare management for members with complex needs.
- Weight Management and Smoking Cessation Education: We provide vital education and resources for weight management and smoking cessation, addressing crucial lifestyle factors that significantly impact chronic conditions. These educational components are integral to promoting healthier lifestyles and improving health outcomes.
Who is Eligible for Condition Care?
Eligibility for Condition Care services is open to members diagnosed with one or more of the following conditions:
- Asthma
- Bipolar disorder
- Chronic Obstructive Pulmonary Disease (COPD)
- Congestive Heart Failure (CHF)
- Coronary Artery Disease (CAD)
- Diabetes
- HIV/AIDS
- Hypertension
- Major Depressive Disorder – Adult
- Major Depressive Disorder – Child/Adolescent
- Schizophrenia
- Substance Use Disorder
If you or someone you know is managing one of these conditions, the Anthem Condition Care program could be a valuable resource for improved health management and support.
Referring a Member to Condition Care
Referring a member to the Condition Care program is a straightforward process. Simply complete our Condition Care Referral Form and email the filled form to [email protected]. We are committed to making the referral process as easy as possible for healthcare providers and ensuring seamless access to our program for eligible members.
[Imagine an image of a doctor and patient discussing a care plan]
Alt text: A doctor and patient collaboratively reviewing a personalized care plan, emphasizing the member-centric approach of the Anthem Condition Care program.
Program Goals and Features: Driving Better Health Outcomes
The Anthem Condition Care program is strategically designed with specific goals and features to ensure its effectiveness and positive impact on our members’ health journey. Our core program objectives include:
- Addressing Gaps in Care: We proactively identify and bridge gaps in care, ensuring members receive comprehensive and continuous support.
- Improving Disease Process Understanding: We empower members with knowledge by enhancing their understanding of their specific disease processes, facilitating better self-management and informed decision-making.
- Enhancing Quality of Life: Ultimately, our program strives to significantly improve the quality of life for our members, enabling them to live fuller, healthier lives despite their chronic conditions.
- Fostering Collaborative Goal Setting: We promote collaboration between members and their healthcare providers to develop member-centered goals and tailored interventions.
- Strengthening Provider-Member Relationships: By providing support and resources, we aim to strengthen the relationships between network providers and their members, fostering a more connected and effective healthcare experience.
- Increasing Program Awareness: We are dedicated to increasing awareness of Condition Care programs among network providers, ensuring they are informed about this valuable resource for their patients.
- Reducing Acute Care Episodes: A key goal is to reduce the frequency of acute episodes requiring emergent or inpatient care through proactive management and preventative strategies.
- Identifying and Addressing Social Determinants of Health: We recognize the impact of social determinants of health and actively work to identify and address these factors by connecting members with appropriate community resources.
[Imagine an image showing a network of community resources supporting a patient]
Alt text: Illustration depicting a network of community resources, such as transportation, food banks, and support groups, highlighting the program’s focus on addressing social determinants of health for Anthem Condition Care members.
Key features of the program that enable us to achieve these goals include:
- Proactive Population Identification: We utilize proactive processes to identify eligible members and ensure timely enrollment in the program.
- Evidence-Based Program Content: Our program content is rigorously developed based on evidence-based national practice guidelines, ensuring the highest standards of care.
- Collaborative Practice Models: We employ collaborative practice models that involve physicians and support service providers in the member’s treatment planning, creating a cohesive and integrated care team.
- Continuous Self-Management Education: We provide ongoing patient self-management education, encompassing primary prevention, coaching for healthy behaviors, compliance support, and dedicated care management for high-risk members.
- Ongoing Provider Communication: We maintain consistent communication with primary and ancillary providers regarding patient status, ensuring coordinated and informed care delivery.
In conclusion, the Anthem Condition Care program offers a robust and supportive framework for individuals managing chronic conditions. By focusing on member empowerment, coordinated care, and proactive interventions, we are dedicated to helping our members achieve better health outcomes and improved quality of life. For more information or to refer a member, please utilize the contact information provided.
