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Medical Outreach Program

Great-West Healthcare, now part of CIGNA, offers a Medical OutreachSM program, which is an integral part of each health care product we offer. To help members get the most out of their health care coverage, our program integrates three strategic areas:

1. Health Management/Wellness Program

This interactive suite of tools and information helps members proactively manage their health and includes:

  • Great-West Healthcare Healthy Frontiers®: Healthy Frontiers motivates members to proactively adopt healthier lifestyles. Through a personal health coach, the Great-West Healthcare 24/7 Nurseline and tools to make learning fun, Healthy Frontiers can positively impact the health and well-being of members.
  • Health & Wellness Web Site and Tools: Provide a comprehensive suite of health, medical and wellness information, including an online health and well-being assessment, condition-specific assessments, daily health news, symptom guides, medication information, support group information, details on more than 1,500 medical tests and frequently asked questions on complementary medicine.
  • Great-West Healthcare Great BeginningsSM: Helps promote healthy pregnancies and prevent premature births. Members receive 24/7 access to a registered nurse, valuable child health and safety information, books and related references.*
  • Great-West Healthcare 24/7 Nurseline: Offers confidential counseling and immediate health care support.

2. Disease Management

Disease Management helps members manage chronic conditions like asthma, chronic pain, coronary artery disease, diabetes, emphysema, end stage renal disease and heart failure and acute conditions including cancer*, high-risk pregnancies* and premature births*. The program works as follows:

  • We use our online health and well-being assessment and member claims to help identify and enroll members in the program as early as possible
  • Once enrolled, members receive ongoing, condition-specific information that helps them lead healthier lives and recognize issues before they become severe
  • A nurse is assigned as a single point of contact to work with members and their doctors when needed for a fully integrated approach
  • Employers pay only for members enrolled in the program
  • We provide reports that capture detailed information specific to client plans

3. Care Management

  • Targets members requiring episodic care, typically for acute conditions
  • Services include precertification and notification, concurrent review and discharge planning and assistance with home visits, help finding community resources, coordination with the member’s doctor and making sure members use appropriate facilities
  • Provides one point of contact to support members and help them navigate the health care system
  • Care management nurses work with our disease management team to coordinate care

*Oncology, neonatology and Great Beginnings programs not available to Great-West Healthcare of California, Inc. HMO members
Measuring Our Success

Since its introduction, the disease management program has garnered successful, measurable results:

  • More than 20 percent of smokers quit during the course of the disease management program
  • Hospitalization rates decreased nearly 35 percent
  • 88 percent of heart failure patients are on vasodilator therapy
  • General mental health improved by 71 percent

In 2008, Great-West Healthcare, now part of CIGNA, was selected as a 2008 Leader in Disease Management by Managed Healthcare Executive Magazine. The annual award is bestowed by DMAA upon the one PPO that is the clear leader in commitment to disease management, employing science in the design of its program, excellence in implementation and achieving favorable outcomes using carefully designed measurement methodology.