Care Management

A win-win-win for doctors, patients and employers

Our care management programs are designed to help.

We know that hospital stays and ER visits can be expensive. We also know that when doctors give patients good advice, they don’t always follow it. 

Blue Cross Blue Shield of Michigan’s care management programs can help by keeping patients on track and costs down, whether your employees are recovering from catastrophic injuries, dealing with chronic illness or trying to get back on their feet after surgery.

Select a topic below to learn more about our care management program:

Learning to live with chronic illness
Helping employees cope with serious illness
Getting out of the hospital and on with life
Putting it all together

Our trained nurses can support patients’ unique health care needs.

Learning to live with chronic illness

For your employees, being diagnosed with a chronic health issue doesn’t mean the end of the world. But it does mean their world changes a lot. Blue Cross Blue Shield of Michigan’s Chronic Condition Management program can help them navigate those changes.

The goal of the program is to help people with ongoing health issues learn how to care for themselves. It’s a short-term program that builds the skills employees need to better manage illnesses like:

  • Asthma
  • Diabetes
  • Chronic obstructive pulmonary disease 
  • Congestive heart failure
  • Coronary artery disease

And, ultimately, better control of care can lead to better control of costs.

Employees who use our Chronic Condition Management program are better at staying on their medications and have fewer ER visits and hospital stays.

Most members who are eligible for the program are identified through their claims. But we also get referrals from doctors and family members. Employees can even refer themselves.

Your employees get valuable one-on-one guidance from registered nurse case managers who help them:

  • Understand their illness and learn to recognize warning signs 
  • Make lifestyle changes 
  • Understand medications and how to use them 
  • Use home monitoring equipment 
  • Manage stress 
  • Understand tests results 

With our Chronic Condition Management program, your employees learn to balance their illness with their everyday life.

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Helping employees cope with serious illness

A catastrophic injury or serious illness can be stressful and confusing for your employees. Hospital costs pile up quickly, especially with frequent readmissions.

At Blue Cross Blue Shield of Michigan, we know that informed patients make smarter decisions about their care. That can lower costs and speed up recovery.

Our Case Management program has nurses who give your employees one-on-one support for catastrophic injuries and illnesses like:

  • Stroke 
  • Ventilator use and the weaning process 
  • Cancer 
  • Complex wound care 
  • Multiple traumatic injuries 
  • Spinal cord injuries
  • Serious cardiac events
  • Serious lung conditions
  • Heart disease
  • Neurologic conditions 
  • Organ transplants
  • Premature or high-risk infant care
  • End-of-life care

Employees who use our Case Management program have fewer ER visits and hospital stays, less trouble with depression and better quality of life.

As their care progresses, so does the support. The case manager will check on their progress between doctor visits and help them develop a plan based on individual needs, goals and progress. Here are just some of the things our nurse case managers can do for your employees:

  • Coordinate care
  • Educate them about their illness and treatment options
  • Refer them to community support services 
  • Guide and support employees with end-of-life issues
  • Locate medical supplies or prescribed equipment 
  • Provide information on doctors and hospitals 

Our personalized care will help your employees with whatever life dishes out. And keep hospital stays to a minimum.

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Our programs help employees transition their care from hospital to home.

Getting out of the hospital and on with life

After a hospital stay, the last place people want to end up is back in the hospital. But complications often land patients right back where they started. Sometimes with an expensive ER visit to boot.

The goal of our Care Transition to Home program is to get your employees from the hospital to home and back on their feet as quickly as possible.

We use a very effective process to predict just which patients are at highest risk of readmission. Then we match those patients with nurse case managers who help them:

  • Keep follow-up appointments with their doctor 
  • Look for signs they’re getting worse instead of better 
  • Stay on their medication schedule 
  • Get the home support services they need

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Putting it all together

We know there are a lot of decisions to make when it comes to health care. It’s up to you to make the best choices for the health of your company and your employees.

When you need a partner to support those decisions with excellent, personalized care, contact us and let us know how we can help.

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