Care Management Services

Care Management Services

We custom-tailored our programs to suit the needs of our clients’ program members. Available services include:

  • Care Management and Care Coordination
  • Health Risk Assessments
  • Functional Assessments
  • Wellness and Prevention (EPSDT)
  • Health Risk Stratification
  • Utilization Management
  • Complex Case Management (Integrated Holistic Management of Physical Health, Mental Health and SATP Clinical States)
  • Disease Management
  • 24/7 Nurse Triage Line
  • Drug Utilization Management
  • Network Development
  • Credentialing
  • Provider Education
  • Member/Provider Relations
  • Member/Provider Call Center
  • Actionable Health Analytics
  • HEDIS Reporting
  • Quality Management and Continuous Quality Improvement (CQI)

Our philosophy and expertise in medical care management enable us to provide comprehensive and affordable administrative and clinical solutions, enriching the lives of program members. We strives to improve our programs and business processes, endeavoring to lead the medical care management industry in improved member outcomes and return on investment. Our business and service model is anchored in the belief that contracted physicians, health care providers, members, their families and the community are essential to success.


Disease Education

Disease Education

CHS provides education and information for a variety of health concerns including the following chronic conditions:

Diabetes

Some people call this illness “sugar in the blood.” It means your blood sugar levels are higher than they should be. Everything we eat turns to sugars, which give our bodies energy. Sometimes our body does not know how to use this sugar, which causes diabetes. There are things you can do to control your diabetes, like eat a healthy diet and take the medicine as your doctor tells you to. Our nurses can help you understand more about diabetes and make plans to take good care of yourself.

Asthma

Asthma is a disease that is chronic, which means that you will have it all your life. Even though it is chronic, you can control it by following your doctor's plans for you. Asthma affects the tubes that carry air in and out of your lungs. It makes the tubes spasm and narrow. When this happens, more mucus than usual is made. This makes it harder for you to breathe. It is very important for you to take your medicines as your doctor tells you to in order to control your asthma. Our nurses can help you understand more about asthma and make plans to take good care of yourself.

COPD

COPD stands for chronic obstructive pulmonary disease. What this really means is you have a type of lung disease. Air flow through your lungs is blocked, which makes it hard to breathe. This develops over many years and is made worse by smoking. Your doctor will help you take care of your COPD by doing tests, helping you get rid of things around you that make you worse, and by giving you medicine. It is so important for you to follow your doctors plans for your care. Our nurses can help you understand more about COPD and make plans to take good care of yourself.

Sickle Cell Disease

Sickle Cell disease is an inherited blood disorder that affects red blood cells. People with sickle cell disease have red blood cells that contain mostly hemoglobin* S, an abnormal type of hemoglobin. Sometimes these red blood cells become sickle-shaped (crescent shaped) and have difficulty passing through small blood vessels. Our nurses can help you manage your disease and keep you on a healthy track.

Hypertension

Hypertension is another name for high blood pressure. This happens when the pressure inside of your large arteries is too high. Because it is silent, the only way to find it is to have your blood pressure tested. High blood pressure is a very common problem that affects many people. How your doctor treats high blood pressure depends on your case and any other illnesses you have. Your doctor may want you to eat well and exercise. Your doctor might also give you medicine to take. Our nurses can help you understand more about high blood pressure and make plans to take good care of yourself.

Coronary Artery Disease

Coronary Artery disease is also known as CAD. This is the most common form of heart disease. It means your blood vessels have become blocked by plaque, which is made up of many things that float in your blood. This build up makes it hard for your blood to flow as it should. There are many things you can do to control CAD which your doctor can tell you about. These might include stopping smoking, eating well, and taking medicine. Our nurses can help you understand more about heart failure and make plans to take good care of yourself.

Congestive Heart Failure

There are two types of heart failure. The first is when your heart can't pump well, so less blood is pumped out with each beat. The other is when your heart can't relax between beats and keeps your heart from filling with blood the way it should. Having heart failure is very serious, but if you take good care of yourself and follow your doctor's plans, you can control it. It is very important to take your medicine as your doctor tells you, and call your doctor if you have trouble. Our nurses can help you understand more about heart failure and make plans to take good care of yourself.