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Published byChloe Nash Modified over 9 years ago
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Knox-Keene licensed since 1983 Medicare HMO with multiple products to serve the member: ◦ Standard MAPD ◦ Dual Special Needs Plan (D-SNP) ◦ Multiple Chronic Special Needs Plans (C-SNPs) C-SNP for individuals with Diabetes C-SNP for the Chronically Mentally Ill C-SNP for individuals with Major Depression C-SNP for individuals with Dementia C-SNP for individuals with Congestive Heart Failure (2015) 2
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Competitive Benefit Plans C-SNPs have “Paired Benefit Plans”: ◦ One for individuals with Medicare only and ◦ One for individuals with Dual Coverage (Medi-Cal and Medicare) All C-SNPs are allowed to enroll year round C-SNPs offer an alternative to Cal- MediConnect 3
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T Mobile Apps Telserve Secure Cloud Database Telserve Secure Cloud Database Wireless BGM Monitoring & Support Intervention & Coaching Education Library Patient Portal Care Team Portals DME & Rx Delivery Home Delivery Tracking by Usage As part of the Member Portal Smart Phone Interface BND Member Diabetic Website Health Coaches to Support member, Caregiver, PCP & IPA. Develops ICP PCP/IPA Care Manager Website By 24 hour Care Team Of Certified Diabetic Educators Cellular Diabetic Meter 4
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I.24/7 Monitoring of Acute Alerts II.Acute Intervention Coaching III.Personalized Coaching IV.Patient ICP Covering BND’s 7 Fundamentals of Chronic Care Disease Education including complications Nutrition Exercising Self Testing Medication Adherence Preventative Care Plan Community Linkage 5
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Monitor acute alerts via Notification Reports Outreach to members through messaging Live intervention & coaching at teachable moment Education assessments for at-risk members Develop member educational plans Conduct ongoing education for at-risk members Provide educational library and content Chart progress and report to BND case managers 6
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Clinical data repository allows real-time data monitoring Care team dashboard reporting on stats, trends, alert lists, adherence to script, and patient information Tools that support clinician interaction Escalate just-in-time interventions Messaging to device, phone, or email based upon glucose readings Self management library Triggered messages Priority messages 7
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#TriggerDefinition 1Sustained HighsAny user who has had 5 consecutive readings of >250 mg/ML 2Sustained LowsAny user who has had 3 consecutive readings of <70 mg/ML 3Pattern HighsAny user who has had 3 readings of >250 mg/ML with the same tag in 7 days 4Pattern LowsAny user who has had 2 readings of <70mg/ML with the same tag in 7 days 5Pattern Low – FastingAny user who has had 2 readings of <70mg/ML before breakfast in 7 days 6Extreme LowAny user who has a BG <50 mg/ML 7Extreme HighAny user who has a BG >350 mg/ML 8
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Any Questions? Thank you for your time. Brand New Day 5455 Garden Grove Blvd., Suite 500 Westminster, CA 92683 (657) 400-1900 brandnewdayhmo.com 9
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