Integrated Care Model for plans purchased on the Health Insurance Marketplace benefits patients and physicians

An Integrated Care Model affords members with Empire plans purchased on the NY State of Health Marketplace (also called the Exchange) the ability to have continuity of care for certain conditions.  A single Primary Care Nurse provides case and disease assessment and management.  This continuity provides opportunity for the member to get assistance working through an acute phase of an illness and then work with their nurse on the behavioral changes needed to help improve their health and enhance their well-being. The program is based on nationally recognized clinical guidelines and serves as a supportiveadjunct to physician care.

 

The Integrated Care Model helps Exchange members better understand and control certain medical conditions like diabetes, COPD, heart failure, asthma and coronary artery disease.  Our nurse care managers are part of an interdisciplinary team of clinicians and other resource professionals that are there to support members, families, primary care physicians and caregivers. 

 

Nurse Care Managers encourage participants to follow their physician’s plan of care; not to offer separate medical advice. In order to help ensure that our service complements the physician’s instructions, we collaborate with the treating physician to understand the member’s plan of care and educate the member on options for their treatment plan. 

 

Members or caregivers can refer themselves or family members by calling the number located below.  How do you contact Case Management?

• Via phone at 1-800-563-5909, Monday - Friday 8:30 am to 7:00 pm EST
• Via Email at ECM-NY@empireblue.com