Today's care manager is often faced with
challenging members who require more complex care management. Many
people struggle with a variety of chronic conditions and may not
have the knowledge or wherewithal to effectively interact with the
health care system. Others simply have a difficult time engaging
with their doctors, which compromises the effectiveness and
efficiency of their care.
Alineo Clinical Programs equip health care payers with advanced
resources to better address these situations. Alineo Clinical
Programs is a set of 30 clinical programs that help simplify the
management of members with chronic diseases and those with complex
health concerns that require case management. They include a
disease-specific health risk assessment, plan of care content
(problem list, goals, barriers, interventions and outcomes), member
educational material, recommended measures for reporting plan
progress and the effectiveness of a case or disease management
program and a recommended risk-based intervention schedule for each
module. The programs are embedded in the Alineo workflow for
maximum consistency and efficiency.
Each Alineo Clinical Program is based on a comprehensive review
of the medical literature using recognized, publicly available
national standards and evidenced-based clinical practice guidelines
with the content complete toolkit of member and physician
correspondence tailored to member-specific problems and
interventions. These are derived from a multi-dimensional health
risk assessment that determines the severity of each condition
along with the member's readiness to change, daily living
activities and condition interdependencies.
The various Alineo Clinical Programs are based
on nationally recognized clinical information for each disease
state and create a basis for member education and intervention
strategies. The programs provide condition-specific assessments and
opportunities for targeted education to improve health outcomes.
Members learn about their individual disease state, medications,
lifestyle issues and adherence to their provider's treatment
plan.
Alineo Clinical Programs includes a clinical module with which
case managers can assess common risk factors that will affect
member outcomes across the care continuum. The health risk
assessment provides the tool for the care manager to assess
specific areas of clinical management based on national clinical
practice guidelines. These include the following types of
disease-specific information common across all programs:
- Depression screening
- Controlled risk factor assessments (e.g., tobacco use, weight,
BMI, alcohol use)
- Treatment adherence and self-care practices
- Medication contraindications versus noncompliance
determination
- Medication non-adherence issues
- Healthcare utilization: Assessment of routine medical
evaluation and/or testing
- Annual flu shot assessment
- Readiness to change assessment
Today's care manager is often faced with challenging members who
require more complex care management. Many people struggle with a
variety of chronic conditions and may not have the knowledge or
wherewithal to effectively interact with the health care system.
Others simply have a difficult time engaging with their doctors,
which compromises the effectiveness and efficiency of their
care.
Alineo Clinical Programs equip health care payers with advanced
resources to better address these situations. Alineo Clinical
Programs is a set of 30 clinical programs that help simplify the
management of members with chronic diseases and those with complex
health concerns that require case management. They include a
disease-specific health risk assessment, plan of care content
(problem list, goals, barriers, interventions and outcomes), member
educational material, recommended measures for reporting plan
progress and the effectiveness of a case or disease management
program and a recommended risk-based intervention schedule
for each module. The programs are embedded in the Alineo workflow
for maximum consistency and efficiency.
Each Alineo Clinical Program is based on a comprehensive review of
the medical literature using recognized, publicly available
national standards and evidenced-based clinical practice guidelines
with the content complete toolkit of member and physician
correspondence tailored to member-specific problems and
interventions. These are derived from a multi-dimensional health
risk assessment that determines the severity of each condition
along with the member's readiness to change, daily living
activities and condition interdependencies.
The various Alineo Clinical Programs are based on nationally
recognized clinical information for each disease state and create a
basis for member education and intervention strategies. The
programs provide condition-specific assessments and opportunities
for targeted education to improve health outcomes. Members learn
about their individual disease state, medications, lifestyle issues
and adherence to their provider's treatment plan.
Alineo Clinical Programs includes a clinical module with which case
managers can assess common risk factors that will affect member
outcomes across the care continuum. The health risk assessment
provides the tool for the care manager to assess specific areas of
clinical management based on national clinical practice guidelines.
These include the following types of disease-specific information
common across all programs:
Depression screening
Controlled risk factor assessments (e.g., tobacco use, weight, BMI,
alcohol use)
Treatment adherence and self-care practices
Medication contraindications versus noncompliance
determination
Medication non-adherence issues ("Do you take your medications
exactly as your provider recommends?")
Healthcare utilization: Assessment of routine medical evaluation
and/or testing
Annual flu shot assessment
Readiness to change assessment