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Table of Contents

Process Group

Care Management

Objective

Identify target beneficiaries for chronic disease management programs

Input

  • Diagnosis

  • Eligibility

  • Demographics

  • Geography (address for beneficiary)

  • Treatment plan

  • Pharmaceutical treatments

  • Provider

  • Rules

Output

  • List of beneficiaries with chronic disease management needs

  • Care management case identifier

Measurable Outcomes

  • List of beneficiaries in need of care management