Disease Management

When employees become partners in their health care, medical costs decrease while their quality of life improves.

The Purpose
To facilitate optimal medical care and manage health plan costs by educating employees and their dependents regarding their health conditions, steering them into the most appropriate, cost-effective medical settings and treatment plans, and consulting with their care providers regarding treatment options.

The Process
The IMA Health Director combines comprehensive, traditional approaches to care management with innovative strategies such as trigger diagnostic review and disease management. Early identification of targeted conditions (e.g., diabetes) can prevent serious, costly complications.

IMA's health staff includes registered nurses, supported by a board-certified medical specialist who is knowledgeable in medical management issues and quality assurance standards. Director assignments take into account areas of specialization: Maternity/Newborn, Oncology, Transplant, Rehabilitation, Psychiatric/Substance Abuse, Pediatric and Medical/Surgical.

Special programs and resources keep patients informed about their treatment options. Health Director staff frequently confer with members of medical teams and, when appropriate, propose alternative efficacious treatment plans.

Primary Features
• Patient/family education.
• Large case management.
• Maternity management.
• Trigger diagnosis review.
• Pre-certification, including inpatient and outpatient review.

Additional optional features
• Disease management.
• Demand management.
• Expanded maternity management.

Key Benefits
Plan participants become partners in their health care, reducing the cost of care, minimizing time lost from work, and improving their quality of life. Preventable medical procedures and unnecessary hospital admissions are curtailed.

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