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Why wellness solutions work

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Did you know?

Dropping just 5 to 10% of your weight can lower blood pressure, cholesterol and blood sugar.*

*National Heart, Lung and Blood Institute website: Facts About Healthy Weight (accessed March 2014): nhlbi.nih.gov/health/prof/heart/
obesity/aim_kit/healthy_wt_
facts.htm.

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A focus on better, overall care

Learn about our approach

At Empire, we focus on better, overall care for every person

We also reach at-risk people with personalized, consumer-friendly wellness programs. It's our approach to lowering your health care costs — and each day, we see it show results.

We also work with doctors

The doctor-patient relationship is central to good health. That's why we were the first in the nation to improve primary-care reimbursement and reward doctors when they deliver high-quality, cost-effective care. Also, through our patient-centered care programs across the country, we're driving a team approach to health that's improving care and lowering costs.

We do this by:

  • Giving doctors meaningful and actionable information, like our high-risk patient report. This way, they can better care for their sickest patients.
  • Offering doctors access to more information, like a comprehensive claims history, including visit, lab and pharmacy claims. This helps them get a complete picture of a patient's health and makes sure they can deliver coordinated, efficient and convenient care.
  • Rewarding doctors when they meet nationally recognized quality measures, while lowering health care costs. We're rewarding doctors who follow up with patients to make sure they fill their prescriptions and understand dosage instructions, respond to emails, and offer longer office hours or web-based visits.

We've found our approach works. In just two years, participating doctors reduced emergency room visits by 15% and inpatient stays by 18%.They also improved performance on diabetes quality measures.*

Our solutions

ConditionCare

ConditionCare identifies, engages and supports employees and their covered dependents who are living with one or more serious health issue. Members can speak to a nurse coach and a team of specialists to better understand their condition and follow a care plan.

ComplexCare

Nurse coaches who are trained in handling complex health issues work with employees and doctors to treat these difficult problems. For every dollar spent, ComplexCare returns $1.98 in health savings.1

Case Management

Expert nurse coaches help members find and get the right care after a hospital stay or a big health issue. This is one-on-one support to help employees see what benefits, treatments and therapies are best.

Future Moms

Each pregnancy is different. That’s why we offer personalized support to help moms-to-be make choices that may result in healthier pregnancies. The program’s nurse coaches help members learn how their choices affect their health and their baby’s health.

MyHealth Coach

A health coach is ready to answer questions about common health topics, such as weight-loss plans, stress management, better eating habits and quitting smoking. This extra support helps employees and their families reach their health goals.

MyHealth Advantage

We go through health histories, pharmacy claims and doctor visits, and then connect the dots to find ways to help employees avoid health problems, stay healthy or save money. If we find something they could change, we’ll send a MyHealth Note in the mail.

ConditionCare Support Programs

Members with cancer, vascular or musculoskeletal diseases, or low back pain have 24-hour access to nurse coaches to help them manage their health. The program is backed by a team of health care professionals, including pharmacists, dietitians and exercise physiologists.

ConditionCare End Stage Renal Disease

Assigned nurses help educate employees about their health issue. They guide them throughout the ESRD therapy process. The program helps them stick to their doctor’s treatment plan and prevents hospital stays.

 

Health and Wellness program offerings vary by state. Specific programs are included in your health plan while others may be available for an additional cost. Contact your sales representative or broker for more information.

©2014 Empire BlueCross BlueShield

Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans, serving residents and businesses in the 28 eastern and southeastern counties of New York State. All external sites will open in a new browser window. Please view our Website Privacy Policy for more information.