Chronic Care Management
The Chronic Care Management Program from Partners HealthCare at Home helps patients with chronic illnesses – such as diabetes, heart failure and breathing problems – to better manage their health and achieve the best quality of life possible.
Our clinicians are specially trained and certified in chronic care management, which is a patient-centered approach that helps patients in their homes learn ways to manage their illness. Through coaching and education, patients and families learn self-management skills that help them feel more confident to live a healthier lifestyle.
To learn more about Chronic Care Management from Partners HealthCare at Home or to make a referral, call (844) 744-4200.
How Chronic Care Management Can Help
The management of chronic illnesses has become a critical issue in today’s healthcare environment. At least 50% of home health patients have at least one chronic illness, and that numbers are increasing.
Our Chronic Care Management Program includes five components:
- A patient-centered approach that engages patients and builds relationships and trust
- A collaborative partnership with the patient’s primary care physician and medical team that results in improved care for the patient
- A self-management approach built on the principles of health coaching, evidence-based practice and adult education, which equips patients with the knowledge and tools needed to help manage their disease
- The use of clinical specialists as consultants
- Use of advanced technology that includes telemonitoring and electronic exchange of information among providers
Our comprehensive Chronic Care Management has been proven to produce better health outcomes, including:
- Improved health and quality of life
- Reduced hospitalizations and Emergency Department visits
- Reduced duplication of diagnostic tests
- Reduced medical expenses, including drug costs