Enroll Today in one of our NEW Population Health Programs!

New for 2021! SCMA MIT is offering free resources in Health Coaching, Disease Management, Precision Care Solutions, and Care Calls for all members, spouses, and dependents on the SCMA MIT plan. These plans can help stabilize healthcare spending by helping members control chronic conditions and make healthier lifestyle choices.

Health Coaching

Health coaching is the use of evidence based skillful conversation (motivational interviewing), clinical interventions and strategies to engage and support members in health behavior change.

Our nationally accredited health coaching team includes:

• Registered nurses
• Respiratory therapists
• Certified diabetes educators
• Behavioral health specialists
• Health and well-being professionals

Health coaches collaborate with a member to develop a personalized care plan. A care plan is a set of goals and evidence-based interventions created to assist a member in managing a condition. Through this process, the health coach will help clarify goals, explore options to attain them, enhance personal accountability and realize the benefits of change for their health and quality of life. They are well versed in promoting:

• Self-monitoring skills
• medication compliance
• emotional and physical support
• goal setting and planning skills
• improved understanding of treatment plan 

Disease Management

A chronic disease is generally considered a condition that lasts one year or more, requiring ongoing medical attention and/or limits a person’s daily activities. Our disease management program uses health coaches to engage and support members with chronic disease.

Our nationally accredited health coaching team includes:

• Registered nurses
• Respiratory therapists
• Certified diabetes educators
• Behavioral health specialists
• Health and well-being professionals

All members identified for health coaching receive a welcome letter, quarterly educational newsletter, with best practice reminders for the specific condition. Evidence suggests that a person who receives routine reminders and education on disease management are more likely to adhere to best practice guidelines for their specified condition.

Precision Care Solutions

Precision Care Solutions uses advanced, condition-specific predictive models, which allow for us to identify, outreach and help employees before they have a hospital admission.

Precision Care Solutions offers multiple solutions and modalities to connect with members much earlier to identify and assist members with resolving barriers related to social determinants of health. This approach is empowered by the advance analytics and data integration of Precision Care Solutions. How it works: Members are identified by those who are currently at risk. Showing a small uptick in utilization shows that one could benefit from connecting with our clinical team to aid these members in resolving barriers related to social determinants of health or lack of education in managing their condition.  A registered nurse case manager contacts members to assess needs, coordinate resources, and refer to other programs, if appropriate.

Currently, diabetes and COPD are being managed, with future plans on leveraging Precision Care Solutions to other conditions such as Heart Failure.

Care Calls

Care Calls are performed when Blue Cross Blue Shield receives requests for upcoming services, hospitalizations, and procedures. Calls are made prior to and post service to assist member with treatment plan, medication barriers, and coordination of services such as home health and other community resources the member may need.

The Care Calls RN also collaborates with providers, facilities and other members of the individual’s care team to address any barriers the member may have in following his/her medical treatment plan.  This program can also make referrals to CM, DM, & PCS, if needed.

Care Call Goals:

• Facilitation between member and provider to coordinate and clarify treatment plans, medication regimens, and other needs
• Evaluate the member’s ability to complete care activities post discharge and provide medical, behavioral and social support
• Identify and reduce risk factors that increase hospital readmissions

For more information on any of these programs contact Beth Martin at 803-264-1138 or Echo McAlhany at 1-800-327-1021