Condition Care

The Condition Care Program (CNDC) is based on a system of coordinated care management interventions and communications designed to assist physicians and others in managing members with chronic conditions.

Our mission

The mission of the CNDC program is to improve the health and quality of life for our members served by encouraging member self-care efforts, coordinating healthcare education and providing interventions along the continuum of care.

CNDC services include:

•  A holistic, member-centric approach to condition care, focusing on the needs of the member through telephonic and community-based resources
• Motivational interviewing techniques used in conjunction with member self-empowerment
• The ability to manage more than one disease to meet the changing healthcare needs of our member population
• Weight management and smoking cessation education

Who is eligible?

Members diagnosed with one or more of the conditions listed are eligible for CNDC services:

• Asthma
• Bipolar disorder
• Chronic obstructive pulmonary disorder (COPD)
• Congestive heart failure (CHF)
• Coronary artery disease (CAD)
• Diabetes
• HIV/AIDS
• Hypertension
• Major depressive disorder — adult
• Major depressive disorder — child/adolescent
• Schizophrenia
• Substance use disorder
  

How can I refer a member to this program?

To refer a member to the Condition Care Program, fill out our CNDC Referral Form and email the completed form to Condition-Care-Provider-Referrals@wellpoint.com.

Documents
 

 Condition Care Referral Form

CNDCs are designed to:

• Address gaps in care
• Improve the understanding of disease processes
• Improve the quality of life for members
• Support collaboration to develop member-centered goals and interventions
• Support network provider relationships with members
• Increase network provider awareness of CNDC programs
• Reduce acute episodes requiring emergent or inpatient care
• Identify social determinants of health and address by referring members to appropriate community resources

Program features include:

• Proactive population identification processes
• Programs are based on evidence-based national practice guidelines
• Collaborative practice models to include physician and support service providers in treatment planning for members
• Continuous patient self-management education, including primary prevention, coaching related to healthy behaviors and compliance or monitoring, and care management for high-risk members
• Ongoing communication with primary and ancillary providers regarding patient status

Nine of our programs are National Committee for Quality Assurance (NCQA) accredited and incorporate outreach, education, care coordination and follow-up to improve treatment compliance and enhance self-care.