Care And Disease Management

CareSource® offers care and disease management that can provide a broad spectrum of educational and follow-up services for your patients.

Care Management Program

CareSource’s Care Management Program fully integrates physical health, behavioral health, functional needs, and social determinants of health. Our Care Management Program brings care management, disease management and coordination of services that is data-driven, person-centered, collaborative, and supported by evidence-based protocols to facilitate improved member access, outcomes and satisfaction. The care management program connects members and their families and/or caregivers with a care team to develop an integrated care plan to address all their needs. It combines population health management with a holistic member-centric approach to deliver services across the continuum of care.

We offer individualized education and support for many conditions and needs, including:

  • Asthma
  • Chronic Kidney Disease (CKD)
  • Diabetes
  • Heart disease
  • Depression
  • High blood pressure and cholesterol
  • Low back pain
  • Pregnancy
  • Weight loss
  • Social Determinants of Health (e.g. housing, food, transportation)

CareSource encourages you to take an active role in your patients’ Care Management Programs and participate in the development of individualized care plans to help meet their needs. Together, we can make a difference.

You can now access care plans online through the Provider Portal to easily provide input into your patients’ care plans and consult with care managers.

How to Refer Members to Care Management

Together, we can make it easier for members to manage their care. If you know of a member who may benefit from the Care Management program, please call us at 1-855-202-0415, or you can make a referral through the Provider Portal.

VIEW CARE MANAGEMENT REFERRAL FLIER

Disease Management Program

Our free disease management programs help our members find a path to better health through information, resources and support.

We help our members through:

  • The MyHealth online program for members 18+ to participate in a journey to improve their health
  • Newsletters with helpful tips and information to manage their disease, promote self-management skills, and provide additional resources.
  • Coordination with with care management teams that include nurses, social workers and community health workers
  • One-to-one care management (if they qualify)

Members with specific disease conditions such as asthma, Chronic Kidney Disease (CKD), diabetes, and hypertension are identified by criteria or triggers such as emergency room visits, hospital admissions, and the health assessment. All ages (children, teens, and adults) are eligible. These members are automatically mailed condition-specific newsletters. The materials are available in English and Spanish. Any member may self-refer or be referred into a disease management program to receive condition-specific information or outreach. If a member does not wish to receive newsletters or outreach, they can call 1-844-438-9498.

Benefits to Members and Providers

Members identified in a disease management program receive help finding the appropriate level of care for their condition, and they are encouraged to actively participate in the patient-provider relationship. The program improves the percentage of CareSource members who receive their recommended screenings.

If you have a patient with asthma, diabetes, or hypertension who you believe would benefit from this program and are not currently enrolled, please call 1-844-438-9498.