The American Health Care disease and wellness management (DWM) program is an integrated service that provides seamless evaluation of the patient at every level of care. From identification to recurrent outcome assessment--with stages in between such as risk stratification, care-plan development, coordination of care, and treatment follow-up--American Health Care’s proactive approach to disease management provides consistent delivery of improved medical outcomes leading to comprehensive cost reduction.
The DWM service package incorporates a multi-disciplinary approach to chronic disease management. This approach maximizes the resources of the healthcare team and allows for a more efficient use of healthcare appropriations. American Health Care is a national award-winning leader of innovative DWM services and is committed to optimizing member health through a coordinated collaboration of the member’s healthcare team. The service package has been developed by the company's clinical staff from an evidence-based, medical outcome perspective utilizing peer-reviewed, national practice guidelines as the foundation of member-specific medical collaborations. Individualized member interactions are designed to educate, motivate, and empower members to actively participate in the management of their well-being and remain in control of their chronic disease state and overall health.
American Health Care employs a unique process of physician communication and education to encourage adherence to evidence-based medical practices. The clinical staff has developed a logical sequence of steps, or algorithms, for solving health problems. These algorithms are based on the most current clinical data and expert opinions as published in peer-reviewed medical journals, placebo-controlled randomized clinical trials, and national guidelines.
American Health Care has developed a proprietary and comprehensive computer-based risk-analysis system to identify patients that have specific medical ICD-9 diagnosis codes, CPT4 procedure codes, and drug claim histories. All patients with certain disease states are flagged for possible intervention and assessed for health risk. Intervention consists of several degrees of intensity dependent on quality measures and risk factors associated with the individual patient. Members who have multiple disease states are targeted and encouraged to meet therapeutic goals in all levels of care. As well, those who are at risk of developing disease or co-morbid medical conditions are identified.
This innovative and unique suite, or integrated software package, incorporates three American Health Care components: Health Risk Assessment (HRA), Medical Deficiency Reporting (MDR), and Digital Outcomes Communication System (DOCS). All members with an identified disease state are flagged and risk-stratified according to diagnosis codes, procedure codes, lab data analysis, specific drug claims histories, and individualized HRA results.