Name of Manual - Blue Cross and Blue Shield of Minnesota

Integrated Health Management
Case & Disease Management
Overview Mission Statement
Integrated Health Management (IHM) combines historically
fragmented Disease and Case Management services to provide a
whole person approach to improving member health, working with
members who are facing chronic, complex, catastrophic injuries,
illness or diseases.
IHM clinicians work collaboratively with members, providers, and
the community to promote optimal health, and coordinate access to
services across the continuum of care that is holistic, seamless and
easily accessible.
Clinicians
Licensed Dedicated Nurses/Clinicians, using a collaborative
process, advocate, assess, plan, implement, coordinate, monitor
and evaluate options and services to meet an individual’s specific
health care needs through education and communication of
available resources to promote high quality, cost effective
outcomes for members with medical and behavioral conditions that
require ongoing or intermittent care. Clinicians are required to
maintain an active unrestricted health license in Minnesota.
Program Goals Maximize optimal health and functional outcomes.
Identify gaps in care.
Reach out to the members with the greatest need and educate
them about their condition.
Support and encourage individual accountability for health and
wellness (self-care management).
Help members coordinate their needs and navigate services in
the health care system.
Tailor interventions and outreach to promote the appropriate
use of health care services.
Improve member satisfaction with the health plan and health
care system.
4-24 Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (06/19/12)