[renerian]

I have posted this question before but it has been a long time so I want to post again to see if there are more nurses in DM.

I wanted to know because I would like to approach allnurses about adding a
DM thread.

Thanks,

renerian

[renerian]

Wow, none so far.

renerian

[wincha]

Officially I work in disease management but have alot of other responsibilities as well

[dria]

sorry renerian....i am a traditional CM....try to get all my members into your DM programs....would be interested in participating however as i have a number of members who either dont have a DM program or decline to participate.

[wincha]

Many of the large insurance companies have disease management now. Even medicaid/medicare is starting to have disease management programs.

[renerian]

Thanks for the reply on DM. I was hoping to see someone reply. I know alot of companies have their own DM programs. I was wondering if it would be worth having our own thread but it does not appear to have enough people that are interested.

renerian

[dria]

Originally Posted by wincha

Many of the large insurance companies have disease management now. Even medicaid/medicare is starting to have disease management programs.

I work for one of the "large insurance companies."
However, I work on the self-insured (ASO) side, so it is completely up to the employer group as to whether they opt-in to the disease management programs....not all do.
SO, if I am case managing a member who works for an employer that did not purchase disease management, and his diabetes is poorly controlled, do I tell him "oh thats too bad, your employer didn't purchase anything to help you" or do I spend the time getting him back under control?

I believe in DM and think its great, and would prefer that you "experts" handle these difficult cases. However, it is not always an option, and I would take any opportunity I can to learn from you to better serve my members.

[wincha]

I have seen people post about DM here and on the telephone triage section. There are actually more of us DM is a large part of my job however I have other responsibilities also. We also have some ASO groups that do buy our DM program.

[wincha]

Dri...
What type of DM do you need help in? Does your company do DM for fully insured and if so there will be tools and information to help you with your ASO customers.

[dria]

Wincha,
Very sweet of you to offer. Yes, we do DM for both the ASO and FIs. However, it's been a challenge locating the DM resources...our resources are split into CM and DM areas. Being classified as a CM, those resouces are a challenge to find. However, being creative (and nosy) in finding resources, I've been able to get what I need. Anything that I find helpful is fair game. It's not a matter of needing help in any specific area, I would just like to stay on top of my game...I'm sure you understand if your program is set up so that you manage comorbids as well as the DM diagnosis.
If I ever do have a specific question, I am confident that you DMs will help me...you've been warned!