Use a Condition Management Program

It may surprise you to learn that 80% of health care dollars are spent on just 20% of the population.

According to the U.S. Centers for Disease Control and Prevention (CDC), more than 90 million Americans—almost a third of the United States population—live with chronic conditions that require a substantial amount of treatment. If you or a family member is one of those 90 million, consider participating in a condition management program.

This article will help you learn:

  • What a condition management program is,
  • How condition management programs work,
  • What’s in it for you, and
  • How to find a condition management program.

What Is a Condition Management Program?

Condition management programs are offered by your health plan to help you and your doctor better manage your condition. Note: A “condition” is not necessarily an “illness” or “disease.”

Participation in any condition management program is voluntary, confidential and available at no additional cost to you. None of your personal information is shared with Nortel.

The specific programs vary by health plan, but some of the most common conditions supported by condition management programs include asthma, diabetes, heart disease and pregnancy. If you participate in the program, you’ll receive tools and information to help you take a more active role in your care, including how to:

  • Get the right care at the right time,
  • Follow your doctor’s recommendations,
  • Adopt behaviors that can improve your quality of life,
  • Manage your symptoms, and
  • Avoid situations that could require emergency room visits or hospitalization.

How Condition Management Programs Work

  • Condition management programs combine the most current research on the effectiveness of treatments with individual counseling or case management. You and your doctor can work together to create a customized, effective treatment plan—and the program will help you follow it.
  • The focus is on preparing you to take a more active role in your care, and to emphasize the importance of following your doctor’s recommendations and treatment plans. In addition to coordinating care with doctors to ensure that you receive the right treatment, condition management programs typically provide you with up-to-date information to help you stay educated on your condition. They can also offer personalized support according to the type and severity of your condition.

Keep in mind that condition management programs are not designed to deny medical care. Instead, they encourage you to seek and follow appropriate care. If you or a family member has a chronic condition, you may be contacted and invited to participate in a program. Or you can contact your plan directly if you’d like more information about its condition management program.

What’s In It for You?

Why should you participate in a condition management program? While your doctor is your primary health resource, a condition management program can be a valuable addition to your overall treatment plan.

By partnering with your doctor, carefully monitoring your signs and symptoms, and providing you with knowledge that can help you manage your condition more effectively, a condition management program can help you avoid more serious problems. Think of these programs as an enhancement to the relationship you have with your doctor.

How to Find a Condition Management Program

Contact your carrier or visit your health plan’s Web site for information on specific condition management programs that are offered.