Disease Management
Welcome to WHA's Disease Management site. Together, WHA and Alere® , a National Committee for Quality Assurance (NCQA) accredited organization, provide disease management (DM) services to our members living with the following conditions:
- Coronary Artery Disease (for members 18-64+ years old)
- Diabetes (for members 18-64+ years old)
- Asthma (for members 5-56 years old)
Participant Selection
All the programs are voluntary and participants can choose to "opt out" at any time. Participants selected for the programs are identified through a set of criteria that include the individual's age, ICD-9 codes and the number of inpatient, ER and/or office visit claims associated with the condition. In addition, members are identified through Case Management, Utilization Management and Wellness activities, e.g. Health Appraisals.
Program Services
Once enrolled, your patients will be contacted by a Care Manager from Alere for an initial assessment of their program needs. A staff of well-trained experts in health improvement who consist of nurses, specialists and coaches will help participants in the management of their chronic conditions through interventions that follow the recommendations of nationally recognized sources. Interventions are based on the severity of the participant's condition and may include:
- Telephone contact and coaching by a health care professional regarding nutrition, medication management, physical activity and community resources
- And/Or Mailed educational mailers related to his or her condition
The programs are there to assist you, our partners in healthcare, with encouraging our members to communicate with their health care provider and to comply with their treatment plan. When appropriate, Alere will provide communication of information regarding your patient's progress that may include evidence-based treatment recommendations.
Physician's Role in Identifying Potential Candidates
As a physician, your role is critical to the identification of potential candidates and in helping your patients understand the many benefits of participating in one of these programs. WHA has made it easy for our healthcare providers to refer patients to our programs by making WHA's DM Referral Form available on our Web site. The form can be downloaded, printed and faxed to WHA or completed and submitted on line.
For more information about our Disease Management programs, contact Member Services and ask to speak to a Health Promotion & Disease Management representative. You may also contact Alere directly at (877) 793-3655, Monday through Thursday, 9 a.m. to 7 p.m., Friday and Saturday, 9 a.m. to 6 p.m. PST.
Disease Management FAQs
| WHA Contact Information | Alere Contact Information | |
| Ph: (916)563-2250 | Ph: (877)793-3655 | |
| (888)563-2250 | Hours: Monday through Thursday - 9 a.m. to 7 p.m. | |
| Fax: (916)568-0278 | Friday & Saturday - 9 a.m. to 6 p.m. | |
| TTY/TDD: (888)877-5378 or dial 711 | ||
| Hours: Monday through Friday - 8 a.m. to 5 p.m. | ||
| westernhealth.com |
