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Disease Management

Meritain Health’s Disease Management program helps clients manage their healthcare benefits spending. We do this by identifying members with chronic health conditions and guiding them in good health choices and self-care. The program is URAC-accredited through American Health Holding—Meritain Health’s sister company through Aetna—and targets nine prevalent conditions for which evidence-based guidelines are established to impact health and measure improvements:

 

  • Asthma (pediatric and adult)
  • Chronic Kidney Disease (CKD)
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Chronic pain (from osteoarthritis, rheumatoid arthritis or low back pain) 
  • Congestive Heart Failure (CHF)
  • Coronary Artery Disease (CAD)
  • Diabetes (pediatric and adult)
  • Hyperlipidemia (high cholesterol)
  • Hypertension (high blood pressure)

The goals of the program include improving a participant’s skills, confidence and ability to manage a chronic condition, which can help to ward off possible complications and high-dollar claims. Nurses work to improve the health status of participants by providing education, clinically proven behavioral assessment and modification tools and support to promote good self-care practices and adherence to evidence-based care guidelines.