Disease Management Centralized Care Unit

Healthy Blue Disease Management Centralized Care Unit (DMCCU) is based on a system of coordinated care management interventions and communications designed to assist physicians and others in managing members with chronic conditions.

DMCCU services include:

  • A holistic, member-centric approach to disease management focused on the needs of the member.
  • Motivational interviewing techniques used in conjunction with member empowerment.
  • Disease management programs for asthma, bipolar disorder, coronary artery disease (CAD), congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, HIV/AIDS, hypertension, major depressive disorder (MDD), schizophrenia and substance use disorder.
  • The ability to manage more than one disease to meet the changing health care needs of our member population.

Programs are also available for:

  • Hepatitis C
  • Sickle cell
  • Obesity

DMCCU also offers weight management and smoking cessation services.

Additionally, DMCCU offers Healthy Families which is a six-month program for ages 7-17; designed to assist families in obtaining a healthier lifestyle. This program provides families with fitness and healthy behavior coaching, written nutrition information, and online and community resources. For additional information or to enroll in the Healthy Families program, call us at 888-830-4300.

Mission

The mission of the DMCCU is to improve the health and quality of life for the members served by encouraging member self-care efforts, coordinating health care education and providing interventions along the continuum of care.

Programs

Our programs feature:

  • Proactive population identification processes.
  • Chronic disease care gaps identification.
  • Evidence-based national practice guidelines.
  • Collaborative practice models to include physician and support-service providers in treatment planning for members.
  • Continuous patient self-management education, including primary prevention, coaching related to healthy behaviors and compliance/surveillance, as well as home visits and case management for high-risk members.
  • Process and outcomes measurement, evaluation and management.
  • Ongoing communication with providers regarding patient status.
Objectives

DMCCU objectives are to:

  • Address gaps in care.
  • Improve the understanding of disease processes.
  • Improve the quality of life for our members.
  • Provide opportunities for patient-centered care.
  • Support network provider relationships with members.
  • Increase network provider awareness of DMCCU programs.
  • Reduce acute episodes requiring emergent or inpatient care.
Who is eligible?

All Healthy Blue members with the above conditions/diagnoses are eligible for DMCCU services. Members are identified through continuous case-finding efforts including, but not limited to, continuous case-finding welcome calls, claims mining and referrals.

The Healthy Blue DMCCU and our disease management programs do not advertise, market or promote specific products or services to members or providers.

The Healthy Blue DMCCU and our disease management programs do not have any financial ownership arrangements with anyone who advertises, markets or provides the goods and services we offer.

How to use DMCCU services

Maximize your time

As a valued provider who could use some help in following up with patients, you can refer your asthmatic, bipolar, CAD, CHF, COPD, diabetic, HIV/AIDS, hypertensive, MDD, schizophrenic and substance use disorder patients who could benefit from education or care management to DMCCU.

Get help with treatment plans

In order to assist in managing patients, DMCCU requests your input for patient treatment plans. Disease management information and the most up-to-date clinical practice guidelines are provided to assist you in creating an individualized plan of care.

Receive feedback on your patients

Providers receive feedback on members enrolled in disease management programs via member introduction letters, care plans and telephonic communications. Feedback includes assessment of how well the condition is being managed, adherence to treatment plans, patient goals and psychosocial and safety issues while enrolled in a disease management program. Feedback is provided biweekly, monthly, quarterly, or as needed based on the severity of the member’s condition.

Provider rights and responsibilities

As a participating provider with members enrolled in a disease management program you have additional rights and responsibilities. You have the right to:

  • Have information about DMCCU, including programs and services, our staff and their qualifications and any contractual relationships.
  • Decline to participate in or work with DMCCU programs and services for our members, if contractually possible.
  • Be informed of how DMCCU coordinates our disease management-related interventions with treatment plans for individual patients.
  • Know how to contact the person responsible for managing and communicating with your patients.
  • Be supported by DMCCU to make decisions interactively with patients regarding their health care.
  • Receive courteous and respectful treatment from DMCCU staff.
  • Communicate complaints to DMCCU regarding disease management as outlined in provider complaint and grievance procedure.

These rights and responsibilities are available to you in written format upon request to DMCCU.

The clinical practice guidelines (CPG) for the following chronic conditions are available in the resource area of the secure provider home page. Login is required. CPGs can also be requested at any time.

How can you contact us?

Hours of operation

DMCCU’s case managers are licensed nurses and are available from 8:30 a.m. to 5:30 p.m. local time, Monday through Friday. Confidential voicemail is available 24 hours a day. Care on Call is available 24/7 for our members.

Contact information

Please call 1-888-830-4300 to reach a DMCCU case manager. Your patients can also get information about DMCCU program services by calling 1-888-830-4300.