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Upcoming transition to a Primary Health Coach model

March 28, 2013

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IBC will soon introduce a new approach to health coaching for our members, called the Primary Health Coach model. The new Primary Health Coach model gives members a single point of contact for all issues and concerns related to disease/condition and case management (this combination is called care management).

The following table describes our current care management programs and the changes that will be made as a result of this transition to the Primary Health Coach model:

Program description

Current program

What will change with new model

ConnectionsSM Health Management Program

Disease/condition management that offers eligible members 24/7/365 access to a Health Coach by calling 1-800-ASK-BLUE

Program administered by Health Dialog, an independent company

Program will be administered by IBC Health Coaches

ConnectionsSM Complex Care Management Program

Supports eligible members who have one or more of 16 complex, chronic conditions

Support provided by IBC care management nurses

Program name will be discontinued, but support will continue to be provided by IBC Health Coaches

Case management

Provides members with extra support when dealing with an acute illness, chronic condition, or multiple comorbidities

Support provided by IBC care management nurses

Support will continue to be provided by IBC nurses, who will be called Health Coaches

Fully insured commercial and Medicare Advantage HMO and PPO members will transition to the new Primary Health Coach model on May 6, 2013, and IBC members from self-insured groups will transition on January 1, 2014.

Benefits of a Primary Health Coach model include:

  • The Health Coach remains consistent as members transition across the health care continuum. This consistency ensures patient-centered coaching that is individualized and coordinated.
  • The Health Coach and member can develop a trusted relationship, which fosters higher levels of member engagement and helps members reach their health goals.
  • A Health Coach will have a 360-degree view of a member's complete health record using an integrated nurse dashboard, which puts information at the Health Coach's fingertips. This display features information about the member's condition, prescription drugs, recent diagnostic or therapeutic activities, and patterns of treatment and procedures. Such complete data review allows our Health Coaches to have a more meaningful interaction with a member and improves the customer experience.

What providers need to know

Effective May 1, 2013, providers should refer patients IBC for disease/condition and case management by submitting an online physician referral form. A link to this form is also available on NaviNet? Plan Central in the Administrative Tools & Resources section. Providers who wish to refer their patients via telephone should call 1-800-ASK-BLUE.

Note: As of May 1, 2013, providers should no longer call the Provider Support Line (1-866-866-4694) to make patient referrals.

Effective May 1, 2013, the ConnectionsSM Provider Portal will be discontinued, and providers will no longer receive the SMART? Registry, which is an annual report offering a point-in-time snapshot about specific information on patients with chronic conditions. Instead, providers will continue to have access to similar information for their patients through our Clinical Alerts and the Clinical Care Report, both available on the NaviNet web portal through the Eligibility and Benefits Inquiry transaction.

What members need to know

Members who currently use the disease/condition management program and who have a Health Coach under the current program will be transitioned to a new Health Coach at IBC. These members will be notified of this change by mail and assigned to a new IBC Health Coach.

Members should continue to call the same number (1-800-ASK-BLUE) to reach a Health Coach. Once they indicate that they would like to speak to a Health Coach, their call will be routed to a Health Coach at IBC. Members will continue to have 24/7/365 access to a Health Coach and online educational tools.

If you or one of your IBC patients has any questions about this change, please call Customer Service at 1-800-ASK-BLUE.

NaviNet® is a registered trademark of NaviNet, Inc., an independent company.

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