Members who choose to enroll in HCCP are assigned a care manager who supports them by phone and through home visits. The manager's goal is to anticipate members' needs and problems, encourage preventive care and prevent costly interventions through home-safety assessments and evaluations of medical, functional and psychosocial status.
- Facilitating conference calls between the member, the physician and the care manager as needed to clarify treatment plans, medication regimens or other urgent issues
- Monitoring medication adherence
- Assessing the member's daily living activities and cognitive, behavioral and social support
- Assessing the member's risk for falls and providing fall-prevention education
- Connecting members and their families with professionals who can help them address medical, legal, housing, insurance and financial issues facing older adults
- Helping caregivers access support and respite care
- Arranging access to transportation
- Assisting members in obtaining home health and durable medical equipment
- Referring members to meal delivery programs and advance directive preparation services
Chronic conditions addressed by this program include chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease and diabetes.
Eligibility and Cost
Humana's predictive modeling tools and assessment process identify eligible members based on their disability, comorbidities and chronic care management needs. The Humana Chronic Care Management Program is available to eligible members as part of their benefit plan and at no additional cost. Members can opt out of this program at any time by notifying their care manager of their wishes.
Services are available for Medicare and commercial members 18 years of age and older who have chronic conditions and medium-to high-acuity care-management needs. Members in some Medicare risk groups and administrative-services-only groups are not eligible for services.
The program is not available in Puerto Rico.
For more information about HCCP, please call Humana Health Planning and Support at 1-800-491-4164. Representatives are available to take your call Monday through Friday from 8:30 a.m. to 5 p.m. Eastern time. This line is available for anyone who wishes to refer a Humana member to a care management program, including physicians, social workers, hospital staff, caregivers or members themselves.