Contract Award #: OD-321-20: Care Management Services

 

CHRONIC DISEASE MANAGEMENT 

 

RCMS has designed a Chronic Disease Management Program specifically for PCA Members. 

 

Chronic Disease is the leading cause of death in the U.S.  According to Milken Institute, in 2016 chronic disease treatment cost 1.1 trillion dollars or 5.8% of the U.S. Gross Domestic Product (GDP).

 

One way to decrease the cost of chronic care management is to prevent and/or inhibit exacerbation of chronic health conditions. 

 

We do better when we know better!  That's why we educate our participants on ALL available benefits and services, both private and public.  We educate on current and future healthcare needs, and how to use all available resources to maximize their healthcare benefits.  This approach promotes quality and cost-effective outcomes, while ensuring the process always works in the best interest of the participant. 

 

The Assessment Recording Tracking (ART) System of Disease Management

 

Our Disease Management services take full advantage of 21st-century technology to help Participants manage their chronic conditions more effectively.  ART allows for real-time assessment of data to make patient-specific recommendations for treatment and care.  The patient’s Primary Care Physician (PCP) can then use this information to form a more complete picture of the patient’s health and to treat underlying or exacerbated conditions. 

 

ART uses Bluetooth®-enable equipment and proprietary apps to monitor health metrics, progress and compliance in real-time.  The following are our current Proprietary Health and Wellness Programs:

  1. Heart Efficiency Assessment Recording Tracking (HEART) Program- Cardiovascular Health
  2. Diabetes Health- Diabetic Assessment Recording Tracking (DART) Program- Diabetes Health
  3. Medication-Compliance Assessment Recording Tracking (M-CART) Program-Medication Compliance
  4. Coronary Calcium Screen (CCS) Program-Used as a stand-alone service or in conjunction with our HEART Program.  

 

In addition, RCMS uses a multifaceted approach to Health and Wellness that includes:

 

  • Data mining to identify patients at risk for chronic disease.
  • Surveys and assessments that identify and/or target patients who have poor health management, little or no follow-up care, and/or insufficient medication refills.
  • Care Manager and Interdisciplinary staff outreach to targeted patients for appointment scheduling and transportation, if applicable.
  • Offering disease-specific health education classes/videos/apps.
  • Evidence-based treatment guidelines adherence to target appropriate treatment.
  • Emphasizing the use of generic medications, if applicable, for participant cost containment.
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