The chronic care management program provides an organized approach to care for patients with chronic medical conditions. Your provider will determine if you have two or more condition set of been [or are likely to be] present for six months or longer.
The care coordinator will contact you, and you will receive periodic follow ups with a healthcare navigator over the phone. Your care navigator will assist in managing your chronic conditions outside the providers office. Together, you'll create a roadmap to a healthy living,Which may include:
- Treatment goals
- symptom management
- medication management
- solutions for financial barriers
- community and social services
- outside services or specialist
- periodic reviews of your care plan
- your expected outcomes and prognosis
This program can provide health and personal cost savings by keeping you out of the hospital and decreasing overall emergency room visits.