Congestive Heart Failure Program

We identify members with congestive heart failure (CHF) by monitoring laboratory, medical and pharmacy claims. We enroll members with CHF in our Health Management program automatically. Participants receive materials to improve their self-management skills and ability to work with their doctors to take better care of themselves.

In addition to information and tools to help make positive behavior changes, participants have access to a dedicated health coach — a registered nurse who helps them learn more about their conditions and ways to manage them. By phone or through our online Personal Health Record, health coaches offer support to help participants work with their physicians and develop a self-care plan to take charge of their illnesses. Participants can contact their health coaches as often as they need for support.

The Personal Health Record is a safe and secure Internet-based health record available to members through the My Health Toolkit® feature of our website. With the Personal Health Record, members can access their consolidated health information 24 hours a day, seven days a week. They can track appointments, manage physician contact information, browse health articles and much more.

When enrolled in Health Management, a participant’s health coach can also send tasks and additional information regarding his or her conditions online. Participants can opt out of the program by simply calling their health coaches and declining participation.