Medical Management Guide, 2009, Version 3.0 - Tricare

Page xiiVersion 3.0Medical Management GuideRecovery Coordination Initiatives............................................................................................................................. 87Federal Recovery Coordination Program............................................................................................................ 87Recovery Care Coordinators....................................................................................................................... 87Transition/Coordination of Care............................................................................................................................... 88Transition of Care............................................................................................................................................. 88Service-Specific Care Transition Programs................................................................................................... 89Inter/Intra-Regional Transfer....................................................................................................................... 89Aeromedical Evacuation............................................................................................................................. 90Coordination of Care........................................................................................................................................ 92Coordination from the Military Health System to the Department of Veterans Affairs................................. 92Coordination for Active Duty Service Members in the TRICARE Prime Remote Program.............................. 92Coordination for Exceptional Family Member Program and Special Needs Families...................................... 93Transition/Coordination Challenges................................................................................................................... 95Other Types of Transition/Coordination............................................................................................................. 95Outside the Continental United States and TRICARE Global Remote Overseas Program.............................. 96The Case Management Professional........................................................................................................................ 97Qualifications................................................................................................................................................... 97Education and Experience Requirements.................................................................................................... 97Certification............................................................................................................................................... 98Ethical Practice Standards........................................................................................................................... 98Resources for Orienting and Training the New Case Manager........................................................................... 99Summary................................................................................................................................................................ 100CD-ROM Resources................................................................................................................................................. 100Section IV – Disease Management.......................................................................................................... 105Introduction............................................................................................................................................................ 105Definition, Goals, and Purpose.......................................................................................................................... 106The Current State of Disease Management....................................................................................................... 107Managing Chronic Disease in the Military Health System............................................................................ 107Employer-Funded Health Plans................................................................................................................... 108Cost Savings for Disease Management....................................................................................................... 108Disease Management Components........................................................................................................................ 109Population Identification Processes................................................................................................................... 109Evidence-Based Clinical Practice Guidelines....................................................................................................... 110Fundamentals............................................................................................................................................ 110Department of Defense/Department of Veterans Affairs Clinical Practice Guidelines................................... 112National Guideline Clearinghouse........................................................................................................... 114