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Elizabeth M. Whitehorn, Director

Provider Notice issued 09/27/07

Disease Management Program – YOUR HEALTHCARE PLUS TM

 

To:​ Nursing Facility Providers​
Date:​ September 27, 2007​
Re:​ Disease Management Program – YOUR HEALTHCARE PLUS TM​

On July 1, 2006, the Department implemented a new disease management (DM) program named YOUR HEALTHCARE PLUS TM. Beginning in June 2007, this care support has been extended to long term care (LTC) residents who are DM eligible. YOUR HEALTHCARE PLUS supports HFS providers, including LTC facilities, with the medical management of Medicaid-eligible (non-Medicare) residents, who have complex chronic illnesses. NP Care of Illinois, in conjunction with McKesson Health Solutions, is administering this program.

Over the next several months, you will be receiving additional information regarding YOUR HEALTHCARE PLUS and may be contacted by an NP Care representative to give you a brief presentation. The program goals are to prevent disease exacerbation and reduce avoidable transfers to the hospital. The program is:

  •  A free benefit to LTC facilities.

  •  Available at no cost to eligible residents who suffer from chronic or complex medical conditions.

  •  Designed to benefit medical providers through the added support of Advance Practice Nurses (APN).

  •  Developed to assist LTC staff by complementing the care provided to these residents.

The presence of an Advance Practice Nurse in your facility is not for regulating purposes, nor will the APN provide any patient care services. The program will not replace the medical management your residents currently receive but will enhance your efforts to keep your residents healthy and safe. APNs will:

  •  Integrate into existing facility programs and culture.

  •  Be available to the facility Monday through Friday to interface with patients and LTC staff.

  •  Assess residents monthly, making recommendations and coordinating with the nursing facility clinical team to maintain or improve a resident’s current level of functioning and wellness.

  •  Be available by phone 24/7 for case management and care coordination.

The Department urges you to participate in this valuable program and to encourage your staff to support the participation of your residents who are eligible for this benefit.

Additional information on YOUR HEALTHCARE PLUS can be found at www.yourhealthcareplus.com or by calling McKesson Health Solutions at 1-800-973-6792.

Theresa A. Eagleson, Administrator

Division of Medical Programs