Care Management & Model of Care

These are two ways iCare helps to provide quality care for your patients!

Aurora CompleteCare

Care Management

Care management is a team-based, patient-centered approach designed to assist patients and their support systems in managing medical conditions more effectively. It also encompasses those care coordination activities needed to help manage chronic illness. Care Management is organized around the principle that appropriate interventions for individuals within a given population will move toward the “triple aim” of:

improving the individual experience of care
improving the health of populations
reducing the costs of care for populations

iCare takes a through, evidence-based approach to care management and utilizes data modeling to help ensure that members with the greatest needs are given the highest level of care management resources. Risk Stratification leverages data analytics to place all members, across iCare’s lines of business into high, medium or low care management intervention tiers. Risk stratification takes into consideration members’ medical and behavioral conditions, health care utilization, and social determinants of health.

Referrals Welcome

iCare has multiple avenues for members to be considered for complex case management services, including:

1. Medical management program referral.

2. Discharge planner referral.

3. Member or caregiver referral.

4. Practitioner referral.

If you would like to recommend an iCare member be considered for a higher-level of care management, contact us by calling Customer Service at 1-800-777-4376 and ask to be connected with a Medical Services Assistant.

Model of Care

A model of care defines the way in which health care is delivered, with an ultimate goal to address the needs of people across the course of their illness. iCare's Model of Care provides members access to a fully integrated package that includes a Care Coordinator, a Registered Nurse Case Manager dependent upon the member’s identified needs. When a member is identified as needing care management support, the member receives a comprehensive, integrated assessment accompanied by a comprehensive member-centered individualized care plan.

For a complete description of iCare's Model of Care, view the Model of Care Guide.

Ultimately, the iCare process helps ensure patient compliance with treatment plans, a challenge when working with vulnerable populations. Besides serving as a resource for both members and providers, iCare is here to support physicians who need help with challenging cases. The support system for providers is multi-disciplinary, which includes pharmacy, behavioral health, translation services, as well as member data.

iCare can facilitate the use of alternative delivery options for the provider to use when treating challenging cases. Since iCare follows members in care coordination on a continuous basis, we can advise the provider as to whether treatments have been tried and if they have been successful. By providing this level of collaboration and resources, iCare lends providers another mechanism to "nudge" members into compliance with their treatment plan.

With iCare, providers have extra tools to ensure something as simple as more members attending appointments, or as complex as providing multi-disciplinary support in a comprehensive treatment plan.

iCare participates in WISHIN, Wisconsin’s statewide Health Information Exchange (HIE). When a member is in care management, iCare will work with the member to create a care plan that includes the member’s goals and health priorities. iCare securely sends those care plans along with the iCare care management team names and phone numbers to WISHIN and are visible to participating health systems and providers. We welcome providers to reach out to us to discuss the care plan or to coordinate care. The intent is to provide a more coordinated and supportive web of support for our members.

Questions? Comments? Ideas?

We'd love to hear from you! At iCare, we celebrate the successes of shared responsibility, and we're always looking to build partnerships that achieve health outcomes. That starts with open communication, and we make it easy for you to connect with the right people.