Our care management department consists of licensed clinical (nurses, social workers and counselors) and non-clinical professionals to assess and provide interventions to members based on identified risks and unmet needs. At Aetna Better Health we use a bio-psycho-social model (BPS) to identify members’ needs and assist in their care. We address our members’ behavioral and physical health as well as their psycho-social complexity.
To begin, an integrated case manager performs a health risk assessment to determine the member’s medical, behavioral health and bio-psychosocial status. Case managers collaborate with the member, member’s family, PCP, psychiatrist, substance abuse counselor and any other health care team member to achieve a quality-focused, cost effective care plan. The purpose of case management is to educate members on their specific disease and prevent illness or complications while maintaining or improving their health status.