Care plans are created using evidence-based guidelines tailored to each member's verified disease. They also take into account the responses from the member's disease-specific health risk assessment and dual eligible status, if applicable.
Tier 1 and Tier 2
Members who are placed in one of these two tiers are managed through Medical Home Office by your Primary Care Physician (PCP). Tier 1 and Tier 2 Care Plans are provided to him/her as a reference document and (along with professional judgment) can be used as a resource tool to help you reach your health goals. This Care Plan information is accessible to members and their caregivers via our secure member portal.
Tier 3
Members in Tier 3 are managed through Medical Home Office by your PCP, but this Tier also includes help from a Nurse Case Manager. These Care Plans are developed after further assessment by your Nurse and are shared with you and your PCP. The Nurse will coordinate your care in communication with your doctor(s) and a Social Worker if needed.
Examples of Care Plans