Health and Wellness Programs
GHC offers comprehensive population health management programs for members which include complex case management and disease management. The goal of each of these programs is outlined below.
Complex Case Management
The goal of case management is to make sure you are getting the care that you need to be as healthy as possible. Your case manager will work with you and your providers to understand your health goals and help coordinate services to reach these goals. In addition, your case manager will educate you on treatment options, provide resources, answer questions, and help you stick to your plan of care. Case managers will also help you manage any chronic conditions you have such as diabetes, asthma, COPD, heart failure, anxiety, depression or substance abuse.
Disease Management
Disease management programs help you to understand your chronic condition and give you the tools to make changes and better manage your condition. By better managing your condition, you can prevent complications and improve the quality of your life. Group Health offers the following disease management programs.
- Perinatal (pregnancy)
- Hypertension
- Diabetes
Health Education
Emmi provides interactive content for patients to help them better understand their health care journey, increase participation in their care and inform decision making.
Go To Emmi
Our member newsletter, keeps our members informed and provides education on important topics such as benefits, services, current health and wellness topics.
Go To Newsletters
Clinical Practice Guidelines for Population Health Management Programs and QI Initiatives
Case management processes and algorithms are built upon evidence-based clinical practice guidelines. All case management processes are based on the Case Management Society of America (CMSA) standards of practice. All disease management and QI initiatives and wellness programs are based on evidence-based clinical practice guidelines as outlined below:
| Diabetes |
- American Diabetes Association (ADA)
|
| Hypertension |
- Joint National Committee 8 (JNC 8)
|
| Asthma |
- National Heart, Lung, and Blood Institute (NHLBI)
|
| Depression |
- American Psychiatric Association (APA)
- Clinical Practice Guidelines for the Management of Depression- PMC (NIH)
|
| Anxiety |
- American Academy of Family Physicians (AAFP)
|
| COPD |
- National Heart, Lung, and Blood Institute (NHLBI)
|
| Heart Failure |
- American College of Cardiology and American Heart Association (ACC/AHA)
|
| Perinatal |
- American Academy of Pediatrics and American College of Obstetrics and Gynecology (AAP/ACOG)
|
| Substance Abuse |
- American Psychiatric Association (APA)
- Treating Tobacco Use and Dependence: PHS Clinical Practice Guideline from Agency for Healthcare Research and Quality (AHRQ)
- Substance Abuse and Mental Health Services Administration (SAMHSA)
|
| Wellness and Health Promotion Programs |
- US Department of Health and Human Services Office of Disease Prevention and Health Promotion
- Centers for Disease Control and Prevention (CDC)
- National Institute of Health (NIH)
|
Screening Children and Adults for Behavioral Health Needs
Group Health Cooperative of Eau Claire requires providers to use age-appropriate validated behavioral health screening and assessment tools to identify potential developmental delays, health concerns, or behavioral issues early on, allowing for timely intervention and support. This proactive approach can significantly improve a child's overall development and well-being. The following toolkits and/or clinical practice guidelines are recommended resources when providing care to our members.
General Development and Primary Care Guidelines in Children
- Bright Futures Guidelines for Health Supervision of Infants, Children and Adolescents is the national standard for well-child care. Resources relate to preventive health supervision and health screening.
- Caring for children with autism spectrum disorder.
- Caring for children with ADHD.
- Primary care guidelines for assessing, treating, and referring common behavioral problems in children.
- Primary care guidelines for assessing, treating, and referring common behavioral problems in adults.
- Resources necessary to determine appropriate diagnosis, treatment, and referral of depression and antidepressant medication management.
- Clinical practice guidelines for the appropriate treatment of tobacco use and dependence.
- Clinical practice guidelines for the appropriate treatment of alcohol abuse and other substance use disorders.
Ready to Enroll?
If you are interested in enrolling in complex case management or a disease management program or are a caregiver who would like to refer a member please call Member Services at (888) 203-7770 or (TTY 711).