Case Management Services
Your partner in health.
Because your doctor is a member of Sharp Community Medical Group, you may benefit from the case management services described below. The programs are provided by SCMG at no charge to patients who qualify for these programs.
Sharp Community has a comprehensive Ambulatory Case Management department that includes Complex Case Management and Health, Wellness and Disease Prevention teams. Both teams may be significant resources for you. Features of both programs are listed below.
Complex Case Management Program
This program provides comprehensive care management for members with complex medical conditions requiring long-term, ongoing management. Patients in this program typically have one or more of these characteristics:
- High-cost, high-risk treatment
- Solid organ and stem cell transplants (except corneal and skin)
- New treatments using cutting-edge technology
- Treatment under clinical trial
- Management of members treated out of area requiring close coordination and co-management of care and services with the health plan
- Use of specialized durable medical equipment
- Experimental/investigational treatments
Health, Wellness and Disease Prevention Program
The Health, Wellness, and Disease Prevention (HWDP) program is designed to outreach and support members who are healthy with low health risk to members with rising health risk. HWDP services are available to all individuals enrolled in HMO and ACO delegated plans. It is an opt-out program meaning that you have the right to participate or to decline to participate.
The case manager utilizes telephonic and/or use of face to face contact through tele video visits for outreach to educate about self-management skills, lifestyle modifications, health and wellness coaching, early identification of chronic disease, disease complications, and disease specific educational materials that can be customized to meet specific educational needs, referral to community resources and self-management practices.
Disease specific conditions include diabetes, heart failure, COPD, asthma, coronary artery disease, hypertension and chronic kidney disease.
The program highlights are:
- Disease-specific telephonic and/or use of face to face contact through tele video visits by a registered nurse case manager to improve self-management skills
- Mailing of personalized patient education materials
- Connecting physicians and members to community and social support resources
- Coordination of care plan and goals between the patient, the disease management coach, and the primary care physician
Educational materials related to care guidelines are available online or sent to you based on interest and disease state. Information on Health, Wellness and Disease Prevention includes:
- Healthy weight maintenance
- Smoking and tobacco cessation
- Encouraging exercise
- Healthy eating
- Managing stress
- Avoiding risky drinking
- Identifying depressive symptoms
For more information, call the Case Management Referral Line: 858-499-3040 and choose option 8.
Case Management and Resource Education (CARE) Program
The CARE Program involves:
- Connecting physicians and members to community social service support services
- Providing federal, state and community resources
- Providing member educational materials
- Linking members to health plan disease management programs
Learn more about these programs.
If you think you would benefit from participating in the Complex Case Management, Health, Wellness and Disease Management or the CARE programs, or would like to learn about other Ambulatory Case Management programs, please call
858-499-3040 and choose option 0.