Disease management program.
Based on the health conditions identified by the physical health risk assessments, if performed under sub. (4m), the department shall develop and implement, for individuals who are eligible under sub. (4), disease management programs. These programs shall have at least the following characteristics:
(a)#
The use of information science to improve health care delivery by summarizing a patient’s health status and providing reminders for preventive measures.
(b)#
Educating health care providers on health care process improvement by developing best practice models.
(c)#
The improvement and expansion of care management programs to assist in standardization of best practices, patient education, support systems, and information gathering.
(d)#
Establishment of a system of provider compensation that is aligned with clinical quality, practice management, and cost of care.
(e)#
Focus on patient care interventions for certain chronic conditions, to reduce hospital admissions.