How Chronic Condition Management Works

What is a Chronic Condition?

The program defines a chronic condition as anything that:

  • is contagious or persistent
  • lasts a year or more
  • requires ongoing care
  • is typically progressive
  • limits activities of daily living

Viverae identifies participants appropriate for the Chronic Condition Management (CCM) program through several data-analytic tools, including Member Health Assessments (MHAs), supplemental questionnaires, biometric screening results and medical and pharmaceutical claims information.

From this, Viverae’s clinicians can evaluate each participant’s clinical, humanistic and economic goals, and identify participants’ physical, psychological, functional, economic and environmental needs. Rest assured, Viverae is committed to the highest level of confidentiality to protect the privacy of participants’ health information.

It is important to note that Viverae is able to utilize multiple points for identification of members that should be included in the CCM program. This is unique to Viverae, and insures effective identification of the right members, their specific health needs and identifies the specific and relevant CCM program that will help bring about the necessary lifestyle and behavior changes.

Viverae’s CCM program includes:

  • Identification of members through claims data and self-reported data
  • Adherence to outreach provided for preventive care exams and chronic conditions
  • Adherence and “gaps in care” determined through claims data, clinician interactions and condition-specific questionnaires
  • Unlimited interactions per year (determined by evidence-based protocols, member engagement and clinician discretion)
  • Communication among members, Viverae clinicians and other health providers as needed (including physicians, durable medical equipment vendors and employee assistance programs)
  • Comprehensive, individualized care plans
  • Educational materials provided according to evidence-based protocols, upon member request or by clinician discretion
  • Predictive modeling outreach provided, based on claims data

The CCM program provides consistent reporting and feedback to clients, as well as collaboration with a participant’s physician or health care provider. Viverae’s case management includes evaluation of participants’ goals and outcomes on an ongoing basis to ensure improvement of the overall population’s health.

Learn more about Viverae's Chronic Condition Management program here.

Member Rights and Responsibilities

Provider Rights and Opportunities