Disease Management/Population Health Program (DM/PHP) is based on a system of coordinated care management interventions and communications designed to assist physicians and others in managing members with chronic conditions.
The mission of the DM/PH program is to improve the health and quality of life for our members served by encouraging member self-care efforts, coordinating health care education and providing interventions along the continuum of care.
Members diagnosed with one or more of the conditions listed are eligible for DM/PHP services:
To refer a member to the Disease Management/Population Health Program, fill out our DM/PHP Referral Form and email the completed form to DM-PHP-Provider-Referrals@anthem.com.
Nine of our DM/PH programs are National Committee for Quality Assurance (NCQA) accredited and incorporate outreach, education, care coordination and follow-up to improve treatment compliance and enhance self-care.
If you have patients with one or more of the conditions listed above who could benefit from additional education or care management, we encourage you to refer them to DM.
DM invites your input for patient treatment plans. We provide you with DM information and the most up-to-date Clinical Practice Guidelines to assist you in creating an individual plan of care for your patient.
Providers can access Patient360 to obtain feedback on their patients regarding their care plans and condition management while enrolled in our program.
You have additional rights and responsibilities such as the right to:
A copy of these rights and responsibilities can also be found in the provider manual.
The Clinical Practice Guidelines (CPGs) for the chronic conditions outlined above are available on Availity, our secure provider website. CPGs can also be requested at any time.
Our DM programs do not advertise, market or promote specific products or services to members or providers.
They do not have any financial ownership arrangements with anyone who advertises, markets or provides the goods and services we offer.