North Carolina State Health Plan Launches Expanded Case Management Services for Members
RALEIGH, N.C. – On January 1, 2008, the North Carolina State Health Plan is pleased to launch expanded intensive case management services for members with complex medical needs. The State Health Plan has contracted with SHPS, based in Louisville, Kentucky, to provide case management services through trained and experienced registered nurses with physician support.
“For our members with severe illness, intensive case management services help to improve the member’s quality of care across medical care settings,” said Sherry Hay, director of integrated health management for the State Health Plan. “The program focuses on early identification to assist members with serious medical needs, such as multiple hospitalizations or a sudden, catastrophic event. We are now pleased to add case management services for members with a high-risk pregnancy or an extended neonatal intensive care stay.”
Chronic diseases made up almost 70 percent of State Health Plan costs for members under the age of 65 in 2004, the most recently available data. For that same year, medical benefits for a member with a chronic disease cost an average of $7,400, compared to an average of $800 for a healthy member’s care.
“These expanded case management services help us to ensure the most appropriate care, which, in turn, reduces health risks and controls health care costs,” said George C. Stokes, executive administrator for the State Health Plan. “The services provided by SHPS underscore the State Health Plan’s commitment to quality and cost-effective health care.”
Case management services are made available through the State Health Plan’s healthy living initiative, NC HealthSmart, at no additional cost to eligible members*. Members who are interested in learning more or feel that they may have a need for case management should contact a Health Coach through NC HealthSmart at 1-800-817-7044. The Health Coach will work with the member to determine the need for a referral to case management.
*Members eligible for NC HealthSmart Services are members whose primary health insurance is through the NC State Health Plan, and are not on COBRA.
