According to the American Heart Association (AHA), over 70 million Americans have some form of cardiovascular disease. Our CHD program emphasizes educating members about their health conditions and working with them to take a more active role in their health care. With the help of a nurse care manager, enrolled members will receive education to promote:
With these changes, members will have a good foundation to start down the road to good health and enjoy a better quality of life.
Blue Cross’ multidisciplinary team of healthcare professionals collaborate to ensure each enrollee receives a “whole-person” approach to their disease management by addressing clinical functional, financial, psychosocial, environmental and support system needs.
Our heart care management programs are designed to assist members in effective management of heart disease. This management includes nutrition, exercise, weight management, smoking avoidance and education about heart disease.
The program is available to Blue Cross and Blue Shield of Louisiana, HMO Louisiana, Inc. and Federal Employee Program (FEP) primary members 18 to 80 years of age.
The selection process for our CHD program is based on hospital claims, encounters, and pharmacy and laboratory data. We analyze claims data to assess relative health risk, identify medical conditions and build a member-centric clinical profile.
The program is not available to members who have other insurance as primary, are being actively treated for cancer, a transplant recipient, have ESRD, HIV/AIDs, are a hospice care recipient or nursing home resident. This is a voluntary program and members may “opt out” of the program at any time.
CHD program members are re-enrolled based on nurse assessment for any of the following reasons:
Our Care Management team includes physician advisors, registered nurses, pharmacists and behavioral health specialists.
Physicians receive the following when their patient enrolls:
AHA/ACC Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2006 Update
American Heart Association
If you wish to contact a nurse to inquire about our programs, please call the Case and Disease Management Unit at 1.800.317.2299.
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