Disease Management (DM) PATH

Our disease management (DM) PATH program* complements your care for members chronic conditions like – heart failure, chronic obstructive pulmonary disease (COPD), diabetes, coronary artery disease (CAD) and asthma. We offer outbound calls and ongoing education. Members who benefit from the program are identified monthly via health risk surveys and laboratory results, as well as Utilization management, claims or encounter and pharmacy data. We also identify potential program members from health records, coaching programs, the care and case management process, through self-referral and referrals from you, their doctors and practitioners.

The program supports practitioner care plans by using evidence-based clinical practice guidelines to emphasize how members can prevent complications and flare-ups of chronic conditions.

The DM PATH program provides interventions based on assessments. The services include:

  • One-on-one telephonic health coaching and monitoring based on a care plan created by a registered nurse and other health care staff. The plan is tailored to address the members’ physical, behavioral and emotional health and take into account lifestyle and cultural needs.
  • Ensure that your patients understand how to best manage their conditions. This includes periodically evaluating their health status and sharing that information with you. You are also welcome to contact (insert) to discuss your patient’s current progress.
  • A quarterly electronic newsletter with the latest information on their diseases.
  • Educational tools to help patients understand their diseases, including guidance about:
    — Symptom-management
    — Diet and nutrition needs
    — Treatment options
    — Planning for doctor visits
  • Coordinating care between members and their practitioners, support-services for providers, caregivers and the health plan administrators.
  • Access to community-based support services.
  • Access to culturally and language-appropriate community-based support services.
  • Evaluating members’ satisfaction with the program.

Members are automatically enrolled in the program; but they can opt out at any time by calling our toll-free line. Members who choose to opt out are also welcome to opt back into the program. Program information is available on the EmblemHealth website. Program information is available to members in their primary languages. You can expect periodic updates and other information we collect on your patients. If you have any questions or would like to refer patients to our DM PATH program please call us at 1-888-881-3112, Monday through Friday, from 8:30 am to 8:30 pm and Saturday from 9 am to 7:30 pm.

Additional information on the disease management PATH program is available at http://www.healthways.com/physician_portal_docs/

*Disease Management PATH program offered in partnership with Healthways.