Condition Management

			Manage chronic and severe conditions to improve employee health and reduce healthcare costs.
				Condition Management Product Sheet

Carewise Condition Management combines disease and case management into a single, person-centric approach that helps participants manage chronic and acute health conditions. This approach allows Carewise Health to manage an individual's health, not just condition. It provides the optimal level of care that single-state disease or general case management programs cannot deliver.

• Risk management. Medical and pharmacy claims data are analyzed using predictive modeling tools and over 3,000 proprietary clinical rules to identify individuals with chronic and severe health conditions. Participants are then matched with the most appropriate counseling program to manage their health risk.
• Opt-in enrollment. Voluntary participation ensures that individuals are receptive to making changes in their health behavior, and are motivated to put new information and self-care measures into practice.
• Personalized care plans. Nurse counselors work one-on-one with participants to assess current health status, identify issues and obstacles, set goals, and determine changes needed to improve health. This collection of activities is referred to as the participant’s care plan. Care plans are created and maintained on a proprietary counseling support system, thereby ensuring consistency in the delivery and quality of nurse counseling.
• Web and print communications. Participants receive condition-specific books and health diaries that support the counseling process. In addition, a Web site provides self-service access to research on medical conditions and treatments, exercise videos, healthy recipes and calendar reminders, and trackers for health-related numbers such as cholesterol. Participants also receive personally relevant messages to raise awareness and build motivation regarding specific health issues.
• Clinical improvement reporting. Carewise Health monitors four key performance areas: net savings, clinical outcomes, clinical risk score, and compliance with evidence-based medicine. This information is reported regularly to clients along with continuous feedback on program design and outcomes.

Carewise Health is marketed by SHPS, Inc., a provider of integrated health solutions. SHPS has maintained URAC accreditation for case management since 1999 and disease management since 2002. Carewise Condition Management offers large employers a strategy for managing the cost of chronic disease and other severe health conditions while improving employee health and productivity.