Heart Failure

Data from the Center for Disease Control states that

  • About 5.1 million people in the US have heart failure.
  • Heart failure costs the nation about an estimated $32 billion each year. This total includes the cost of health care services, medications to treat heart failure, and missed days of work.
  • One in 9 deaths in 2009 included heart failure as contributing cause.
  • Early diagnosis and treatment can improve quality and length of life for people who have heart failure.

Program Goals

  • Decrease the need for CHF patients to be admitted to the hospital or visit the emergency room through better control of their disease.
  • Help members with CHF learn self-management skills to better manage symptoms through early recognition and prompt interventions.
  • Improve compliance with medications and daily monitoring of weight.
  • Maximize the member's engagement with the program and measure member satisfaction.
  • Decrease absenteeism and increase productive work time.

Program Interventions

  • Telephonic care management provided by specially trained Registered Nurses, with call frequency set to meet individual needs.
  • Access to a nurse 24 hours a day, 7 days a week for support in managing CHF.
  • Encourage the member to keep physician appointments, follow their care plan, and assist them with coordination of care when multiple physicians are necessary.
  • Assess the individual's knowledge of CHF and causes of symptoms.
  • Educational materials sent to the member based on personal needs.
  • Facilitation of enrollment in a face-to-face educational program as needed.
  • Establish an action plan to prevent and manage worsening symptoms, including when to get help.
  • Proactive goals set by the member, with guidance and encouragement from the nurse.
  • Lifestyle coaching using "motivational interviewing" techniques to foster behavior change.
  • Access to website for CHF education and interactive tools.
  • Facilitate involvement of family/support individuals to maximize success in reaching goals.