Empire Plan Disease Management Program Update

The Empire Plan offers a number of disease management (DM) programs for individuals with a chronic medical and/or mental health condition.  DM programs are available for individuals with:  asthma, cardiovascular/coronary artery disease, congestive heart failure, chronic obstructive pulmonary disease, depression, diabetes and sleep apnea.  All of the DM programs use nationally-recognized clinical practice guidelines and recommendations. Participation is voluntary, free of charge to the participant, and confidential.

By providing members with education and support, and reinforcing the importance of adhering to their physician’s treatment plan, these programs help members take a central role in managing their care and fostering a sense of responsibility for their own health.  The goal of the DM programs is to maximize participants’ well-being and to reduce or delay the need for more advanced or costly medical interventions.

Three new DM programs began on July 1, 2008.  ValueOptions, the company that manages mental health and substance abuse services for the Empire Plan, is offering DM programs for individuals with Attention Deficit Hyperactivity Disorder (ADHD) and Eating Disorders (anorexia, bulimia, and binge eating disorder).  United HealthCare, through its partner

OptumHealth, is offering a new DM program for individuals with Chronic Kidney Disease.

Attention Deficit Hyperactivity Disorder (ADHD)

The ADHD Identification and Management Program includes:

·         A free, confidential screening tool that you can access online, or request by telephone;

·         Information about ADHD symptoms and treatment; and

·         Assistance in assessing your child’s treatment options and coordinating care among treatment providers.

Parents can learn more about the Program online at www.ValueOptions.com or by calling the Empire Plan at 1-877-7NYSHIP and choosing option #3 for ValueOptions.

Eating Disorders

The Eating Disorders Management Program includes:

·         Information about eating disorder symptoms and treatment;

·         Free eating attitude survey that can be taken online;

·         Assistance in assessing treatment options and coordinating care among treatment providers; and

·         Members with more severe symptoms may be offered intensive care management services.

You can learn more about the Program online at www.ValueOptions.com or by calling the Empire Plan at 1-877-7NYSHIP and choosing option #3 for ValueOptions.

Chronic Kidney Disease

Individuals diagnosed with chronic kidney disease may be invited to participate in the Kidney Resource Services Program.  The Program is designed to identify patients early in their course of treatment and help provide interventions to delay the progression of the disease. If you agree to participate, you will be offered educational materials and other services that may help to improve the management of your kidney disease. You may also be contacted by a Registered Nurse in conjunction with this program.  The Empire Plan must be your primary insurance coverage in order to participate in this program.

You can learn more about the Program by calling the Empire Plan at 1-877-7-NYSHIP and choosing option #5 for the Empire Plan NurseLine.