What Michigan carriers publish for members with chronic and complex conditions.
Each carrier below publishes care management or condition programs for diabetes, heart, lung, kidney, cancer, musculoskeletal and other conditions. Programs, vendors and eligibility vary by plan, funding type and employer group. This page describes each program as the carrier describes it and links to the carrier’s own page. Looking for wellness and rewards instead? See carrier wellness programs → Want fitness and member discounts side by side? See carrier member discount programs → Got a rebate check from your carrier? See what to do with a medical loss ratio rebate →
Blue Cross Blue Shield of Michigan: Disease Management
BCBSM publishes condition management solutions for employers and a nurse-led care team for members with complex needs.
Diabetes and diabetes prevention
Employer condition management solutions describe a connected glucose meter with certified diabetes care and education specialists, and a prevention program with a connected scale, food logging and one to one coaching.
Hypertension and weight management
BCBSM lists a Teladoc Health hypertension program with a connected blood pressure monitor and chronic care professionals, and a weight management program with a smart scale and a certified health coach.
Blue Cross Coordinated Care
A nurse-led care team that can include pharmacists, dietitians, social workers and behavioral health specialists for members with chronic or complex conditions.
Muscle and joint health
A virtual program for BCBSM and BCN plans, delivered with Hinge Health, with physical therapists, health coaches and guided exercise.
Home biometric monitoring (AMC Health)
Home monitoring for members with congestive heart failure, COPD or uncontrolled hypertension. BCBSM lists it in a provider authorization document for Medicare Plus Blue and BCN Advantage.
Kidney care (Strive Health)
Enhanced care management for members with stage 4 or 5 chronic kidney disease or end stage renal disease, in listed counties.
Catastrophic case management (Enlyte)
Case management for high acuity, complex needs on Blue Cross and BCN commercial plans, for members engaged in Coordinated Care and referred by its staff.
Behavioral health
BCBSM’s employer page lists Coordinated Care, Blue Cross Well-Being and Virtual Well-Being for behavioral health, mental health and substance use support.
What to confirm
BCBSM states the employer programs are included for fully insured members and available as a buy-up for self-funded groups. Coordinated Care and Muscle and Joint depend on the member’s plan and eligibility.
Priority Health: Disease Management
Priority Health combines care management for chronic conditions with digital diabetes programs that vary by employer group.
Care management
Health professionals work with the member and their doctor to coordinate care for chronic conditions, recent hospital stays or multiple medications. Condition resources cover diabetes, kidney disease, cancer, mental health, hypertension and heart disease.
Virta for type 2 diabetes
A digital program with customized care plans, biomarker based coaching and an on demand clinician led care team.
Livongo for type 2 diabetes
A digital program with health coaching, a connected glucose meter and app support. Per Priority Health’s provider manual it applies to groups that have the Livongo buy-up.
Omada and the National Diabetes Prevention Program
Lifestyle change programs for members with pre-diabetes or at risk, covering healthy eating, activity and stress management with peer support.
Virtual pulmonary rehab (Kivo)
A nine week at home, clinician led virtual recovery program for members with COPD.
Remote condition monitoring
Members who meet clinical criteria for congestive heart failure, COPD or diabetes can get monitoring devices such as a blood pressure cuff, scale or pulse oximeter.
PriorityMOM
Supports expectant mothers through pregnancy and postpartum.
Kidney, diabetes and hypertension care management
A care manager connects members to resources and in network doctors and educates on kidney disease, diabetes and hypertension.
Teladoc mental health
Online coping tools and coaching for depression, anxiety, stress and chronic pain, with 24/7 behavioral clinician access.
What to confirm
Which diabetes program applies depends on the employer group. Ask Priority Health which one your group has before promising it to employees.
Health Alliance Plan: Disease Management
HAP publishes a diabetes program and a care management program. Its public pages do not document condition by condition programs beyond these.
Diabetes Care Connection
A physician supported program, powered by Populance, with coaching, self management training, medical nutrition therapy and support for diabetes in pregnancy, at no copay or cost share per HAP.
Care management
HAP case management staff work with the member and their providers to follow a treatment plan. Members, doctors, family members or caregivers can refer.
Transitional care management
A case manager calls after a hospital stay to coordinate care, answer questions and support follow up visits.
Diabetes Prevention Program
A year long, coach led lifestyle program on healthy eating, activity and weight management with peer support, run with the National Kidney Foundation of Michigan and Henry Ford Health.
Digital musculoskeletal program
A virtual platform from Protera Health with telehealth consults, physical therapy, nutrition counseling and pain management education.
Maternity care management
Nurse care manager support through ProgenyHealth, a case manager phone line, the Ovia Health app and 24/7 telehealth. HAP also lists a postpartum depression screening program.
Palliative care and Hospital at Home
Home based palliative care alongside the member’s care team, and hospital level care delivered at home as an alternative to a facility stay.
Antidepressant medication management
Written outreach, support and education to help members stay on antidepressants consistently.
What to confirm
HAP’s population health page labels programs by audience, such as Medicare Advantage, commercial and self funded groups. It names no dedicated heart failure, COPD or kidney program, so confirm what applies to your group.
UnitedHealthcare: Disease Management
UnitedHealthcare lists clinical support programs by condition, and its employer page says care coordination gives fully insured employers access to condition specific programs.
Diabetes
A disease management program with digital tracking, biometric sensors and the ability to ask coaches questions.
COPD and asthma
COPD support covers risk factors, medication and treatment plans. The asthma program covers triggers, warning signs and following a treatment plan.
Heart failure and coronary artery disease
Heart failure resources help members recognize symptom changes. The CAD program includes individualized care plans and nurse follow up.
Kidney and cancer support
Kidney Resource Services guides members with end stage renal disease. Cancer Resource Services connects members to a network of cancer centers of excellence.
What to confirm
The member page does not state eligibility. UnitedHealthcare’s employer page ties condition programs to care coordination for fully insured employers, so confirm funding type and plan details.
All wellness and rewards programs
UnitedHealthcare’s hub for member support, wellness and rewards programs, including clinical support, fitness, rewards and navigation programs.
Aetna: Disease Management
Aetna offers a nurse supported disease management program and tiered care management for higher risk members.
Aetna Disease Management Program
Pairs members with a registered nurse acting as a personal health coach by phone, email or online, with online condition programs and a 24 hour disease management line.
Online condition programs
Aetna lists diabetes, low back pain, pain management, high blood pressure and high cholesterol among its online programs.
Aetna One care management
Aetna describes care teams for high risk case management, rising risk condition coaching and specialized clinical support, offered in tiers named Essentials, Flex and Choice.
Behavioral health support
Aetna lists an employee assistance program, virtual counseling and behavioral health case management after a hospital stay.
Aetna One tiers
Essentials focuses on short term acute episodes and avoiding admissions. Flex adds a single nurse for the family and an expanded care team. Choice adds group coaching, integrated utilization management and expanded staffing.
Aetna One Advocate and Advisor
Aetna describes these as its high touch care management offerings for complex or chronic needs.
Community Care
Goal based health management with flexible support and coaching for chronic conditions, as described on Aetna’s care management page.
What to confirm
The disease management document is a general Aetna publication, not specific to Michigan. Available programs depend on plan design and contract.
Cigna Healthcare: Disease Management
Cigna lists coaching, care management, cancer support, maternity, lifestyle and behavioral health programs on its employer pages.
Your Health First
Cigna’s employer page describes health coaching for chronic conditions that can be affected by behavior change, including asthma, diabetes and heart disease.
Omada for Cigna Healthcare
A digital program for customers with prediabetes or at risk for diabetes, with a connected scale and a virtual coach. Omada Health runs the program.
Health Matters Care Management
Uses predictive modeling to identify rising risk customers and offers personalized engagement for those with complex medical conditions.
Cigna Health Advisor
One on one coaching for at risk individuals with unhealthy behaviors, aimed at lifestyle change, closing gaps in care and choosing cost effective treatment.
Personal Health Advocates
Advocates work one on one with employees facing complex or high cost conditions such as traumatic injury, high risk pregnancy, chronic kidney disease and oncology to close gaps in care.
Cancer Support Program
Information and assistance for employees and their families from diagnosis through treatment to remission.
Lifestyle Management
Online or phone coaching on goal setting and overcoming barriers for weight, tobacco cessation and stress management.
Healthy Pregnancies, Healthy Babies
Clinical support for families during pregnancy and postpartum, with access to a maternity coach and tools for eligible customers.
Pathwell Bone and Joint
A Cigna musculoskeletal care program for bone and joint conditions.
Employee Assistance Program
Covers mental health, substance use and work life needs, with 24 hour critical incident support, management consultation and wellness seminars. It is separate from health plan benefits.
Chronic condition support
Cigna’s provider library lists individualized support for conditions such as asthma, diabetes, COPD and low back pain, plus case management for oncology, transplant and high risk maternity.
What to confirm
Eligibility and fees vary by employer size, funding type and plan. Optional incentive programs are employer funded and may not be available with every product, so confirm each program with Cigna for your group.
McLaren Health Plan: Disease Management
McLaren Health Plan publishes disease management pages for several conditions, tied to its Community lines of business.
Asthma
Early identification, education and monitoring, with self management tools, trigger education and PCP coordination. Members with an asthma diagnosis are enrolled automatically.
Diabetes
Early identification and education for members and PCPs, focused on core measures such as A1c, eye and foot exams. Members with a diabetes diagnosis are enrolled automatically.
Hypertension
Down with Hypertension helps members follow their doctor’s treatment plan, with newsletters for members and providers.
Chronic kidney disease
Works with members and their doctors on treatment adherence. Members 18 and older with a CKD diagnosis are eligible.
Case management
A McLaren nurse sets goals with the member, builds a care plan and coordinates care with the member’s doctor for serious, complex or multiple conditions.
Depression: Eyes Wide Open
Educates members and providers about depression, increases screening and encourages optimal treatment. Members with a depression diagnosis are enrolled automatically.
Weight management
Nurse provided education on nutrition and exercise plus weight loss counseling for members with an obesity diagnosis.
Sickle cell program
Early identification, education and monitoring with an emphasis on self management and coordination with the PCP and hematologist.
Pregnancy health information
Specialized nurses send what to expect information and answer questions. Breast pumps are covered with a prescription.
Stop smoking
Physician cessation counseling plus covered prescription and over the counter cessation medications.
What to confirm
McLaren’s program pages do not state a line of business such as Medicaid, Medicare or commercial. Confirm with McLaren which programs apply to your employer group.
Humana: Disease Management
Humana has announced it is exiting its employer group commercial medical business. Its remaining chronic care pages are aimed at Medicare and Medicaid members.
Employer group medical exit
Humana announced it will exit the employer group commercial medical business, covering fully insured, self funded and federal employee plans and the wellness and rewards programs tied to them, phased over time. The notice does not name Go365.
Group benefits that continue
Humana’s employer page markets group dental, vision, life and disability. It lists no medical wellness or condition management programs.
Humana Care Management
Telephonic case and care management for chronic and complex conditions with an individualized care plan. The page describes select Medicare and Medicaid members, with no commercial eligibility stated.
Humana Cancer Program
Telephone coaching from certified oncology nurses with education and referrals. The program page lists it for commercial and select self funded members.
Renal Disease Management
Care coordination, medication review, dialysis education and social support for late stage kidney disease and ESRD, published for select Medicare plans.
Specialized Care Partners
Humana lists partner programs for kidney, diabetes, heart, cancer and complex needs, including Monogram Health, Upperline Plus, VillageHealth, Strive Health and Thyme Care. Availability varies by region and plan.
Whole Person Care for group Medicare
Humana’s group Medicare page lists the cancer program, kidney care managers and a prepared meal program for eligible patients recovering at home.
What to confirm
Many of these pages are published for Medicare members. Humana is exiting employer group commercial medical, and no Michigan commercial group page was found, so confirm directly with Humana.
Three questions to put to every carrier.
Which programs come with our funding type?
Many programs are included for fully insured groups and sold as a buy-up for self-funded groups. Ask which apply to your plan and what each costs.
Who runs the program?
Some programs are run by the carrier and some by outside vendors. Ask who a member actually talks to, and whether the vendor can change at renewal.
How does a member get in?
Ask whether members are enrolled automatically, referred by a nurse or doctor, or must opt in, and whether any cost share applies.
Send us your renewal.
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