Chronic Disease Management

Chronic Disease Management

SRS has come to realize from its clients and colleagues that there is a need for a Chronic Disease Management program to better manage those patients who have contracted lifelong illnesses and who need the extra encouragement, education, and management of their disease to keep it from getting to an acute level requiring costly hospitalization or surgery. Spectrum has placed the Chronic Disease Management program with our highly successful Large Case Management program. It is a natural extension of what our Case Managers do for catastrophic illnesses and injuries, and gives them a new avenue to work with the full continuum of care.

The initial health conditions we will focus on are:

	ASTHMA
	CONGESTIVE HEART FAILURE
	DIABETES, TYPE I & II
	HIV/AIDS
	RESPIRATORY COMPROMISE/COPD
	STROKE/CVA
	HYPERTENSION

In a partnership with our payor clients we ask that they assist SRS, through their claims systems, in identifying those patients with the above chronic diseases, combined with SRS's identification process through the standard UM program we should be able to best locate those patients in need of assistance. Once these patients are identified, SRS Case Managers can get involved collectively with the patient, family and attending physician in the care of their illness. Using established clinical protocols, Case Managers can work closely with patients to assure the best outcomes. Through better patient education and professional guidance, patients can learn how to best manage their illness and effect a positive health status. The primary goal of the Case Manager is to act as a catalyst for education, communication, and maximization of health and community resources in reducing the patient's risk for need of acute care due to noncompliance or misunderstanding of their disease process.

We all know that nothing can erase a chronic disease, but a better long term outcome and reduced healthcare costs can be derived from a program of careful management and lifestyle changes.

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