Wide Range of Disease
Management Programs Available

For the past several years, Humana has offered disease management services to its seriously ill and at-risk members, and all of these programs have proven to be effective in both helping members cope with their illnesses and improving outcomes. For example, a recent study on Humana’s congestive heart failure (CHF) program found that 90 percent of enrolled members’ disease stabilized or improved, and that 62 percent of those members had reduced CHF-associated hospital admissions. In addition, 97 percent of those members reported high satisfaction with the CHF program.

Following is an overview of the disease management programs currently available to Humana members:

Congestive Heart Failure (CHF)
The CHF program is designed for members whose disease status meets the New York Heart Association (NYHA) classification of Class III or IV CHF. Provided through an arrangement with CorSolutions, Inc., the program relies primarily on services provided by cardiac-trained critical care nurses, who work to manage and slow the progression of CHF through ongoing education and monitoring in the areas of diet, exercise and lifestyle. For questions or referrals, please call CorSolutions at 1-866-676-0740.

Coronary Artery Disease (CAD)
CorSolutions, Inc. is also contracted to provide Humana’s CAD program, using a comprehensive disease management system called MULTIFIT. Developed at the Stanford University Department of Cardiac Rehabilitation and augmented and licensed exclusively to CorSolutions, the program is tailored to provide care management services for members with high-acuity CAD. Through this nine-month, telephonic program, disease management nurses construct individualized care plans after careful evaluation of each member’s condition. Members are monitored to promote compliance with physicians’ prescribed treatments and therapy; they also receive individualized education and monitoring on a variety of topics, such as diet and exercise. For questions or referrals, please call CorSolutions at 1-866-676-0740.

End Stage Renal Disease (ESRD)
RMS DM has been contracted to assist in the management of Humana’s ESRD members. This program is available to members who have been diagnosed with ESRD and have participated in their first dialysis session. ESRD program nurses provide participating members with a combination of services, monitoring and education — with the goal of decreasing the likelihood of complications, hospitalizations, ER visits and/or onset of other co-morbid conditions. For questions or referrals, please call RMS at 1-800-767-0063. The RMS DM program is not available in Tampa. Nephrology Care Management Systems, Inc. is the ESRD program vendor in Tampa. For more information on the ESRD program in Tampa, call Susan Carol, disease management manager, at (386) 676-1833.

Rare Diseases
Humana has contracted with Accordant Health Services, Inc. to provide services to Humana members with any of the following 13 diseases:

• Amyotrophic Lateral Sclerosis (Lou Gehrig’s Disease or ALS)
• Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP)
• Cystic Fibrosis
• Dermatomyositis
• Hemophilia
• Lupus (Systemic Lupus Erythematosus or SLE)
• Multiple Sclerosis
• Myasthenia Gravis
• Parkinson’s Disease
• Polymyositis
• Rheumatoid Arthritis
• Scleroderma
• Sickle Cell Disease

Program elements are designed to provide comprehensive assistance to members and include:

• care coordination with the patient, family members and health
  care provider(s),
• anticipatory guidance related to management of their disease and associated symptoms and
• 24-hour, toll-free access to specially trained nurses.

For questions or referrals, please call Accordant at 1-800-948-2497.

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