Heartline

Congestive Heart Failure is one of the most expensive chronic illnesses in health care. Through Heartline, Disease Management can help reduce claims costs with preventive care. Through a highly developed proactive approach, costly patient hospitalizations, ER visits, and invasive procedures are reduced.

How the Heartline Program Works:

Pharmacy and claims data is monitored to identify members at a higher health risk for diabetes, cardiovascular disease and/or asthma, and these members will receive the following individualized care management from a Registered Nurse:

• Individuals are contacted about program participation. Program materials are then sent to an individual’s primary care physician, and the individual receives an information packet that explains the program and includes educational materials.
• Program participants are risk-stratified, and our staff performs more intensive interventions with those identified as high-risk. Patients are teamed with their physician, clinic and local area staff who provide:

o Documentation and tracking of medical care, including appointment reminders and referral assistance for support services;
o Assessment of patient progress in self-management programs and reinforcement of any educational and compliance deficits through follow-up contacts;
o Continuous communication to assess and enhance current progress and compliance;
o Toll-free phone service for clinical and behavioral support as needed.

• Central data collection system maintenance for each patient’s private information that serves as their overall plan resource.