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Health Empowerment Program (HEP)
The Pathway Review Systems Health Empowerment Program takes disease management to the next generation. By incorporating benefit plan design to increase participation rates, the Health Empowerment Program assists and manages those emerging high risk members with chronic conditions or the potential for chronic conditions, which may potentially lead to a higher than average claim incurrence. Based on a predetermined list of targeted risk factors and targeted diseases, the Pathway Review Systems Health Empowerment professionals will use a variety of intake methods to identify candidates for the Health Empowerment Program. These intake methods can range from referrals from internal utilization and case management staff, to completion of a health questionnaire by plan participants during open enrollment, to using predictive modeling software to identify those participants yet to be located through traditional disease management intake methods.
Targeted diseases are as follows:
- Arthritis
- Asthma
- Chronic Obstructive Pulmonary Disease
- Congestive Heart Failure
- Coronary Heart Disease
- Diabetes I and II
- High Blood Pressure
- High Cholesterol
- High Risk Conditions
Once participants have been determined to be a possible candidate for Health Empowerment services, they are contacted telephonically by a health professional for a comprehensive and disease specific assessment. Based on the outcome of the assessments, the participant is triaged to the appropriate health empowerment level based on acuity. With that, a personalized care plan is developed, along with the appropriate levels of ongoing telephonic education and monitoring to ensure care plan compliance.
Right of Change
Pathway Review Systems reserves the right to modify the parameters of the services listed above without notice when clinically and/or operationally necessary/warranted. Provision of any services not listed above may be subject to additional fees.
