Condition Care

Our program

Our Condition Care (CNDC) program relies on coordinated care management interventions and communications to assist physicians and other healthcare professionals in managing members with chronic conditions.

CNDC services

Condition Care services include:

• A holistic, member-focused approach to condition care that emphasizes the needs of the member through phone and community-based resources
• Motivational interviewing techniques combined with member self-empowerment
• The ability to manage multiple diseases to adapt to the evolving healthcare needs of our member population
• Education on weight management and quitting smoking

Eligibility

Members diagnosed with one or more conditions listed in this section qualify for CNDC services:

• Asthma
• Bipolar disorder
• Coronary artery disease (CAD)
• Congestive heart failure (CHF)
• Chronic obstructive pulmonary disease (COPD)
• Diabetes
• HIV/AIDS
• Hypertension
• Major depressive disorder — adults
• Major depressive disorder — children/adolescents
• Schizophrenia
• Substance use disorder

Quality of care

If you have patients with one or more of the conditions listed who could benefit from additional education or care management, we encourage you to refer them to CNDC.

Member referrals

Fill out our CNDC Referral Form and email the completed form to Condition-Care-Provider-Referrals@anthem.com.

Program features

Features of Condition Care include:

• Proactive population identification processes
• Evidence-based national practice guidelines
• Collaborative practice models that involve physicians and support service providers in treatment planning for members
• Ongoing patient self-management education, including primary prevention, coaching on healthy behaviors and adherence or monitoring, and case/care management for high-risk members
• Ongoing communication with primary and ancillary care providers regarding patient status

CNDC programs are designed to: 

• Address gaps in care
• Enhance the understanding of condition processes
• Improve members' quality of life 
• Foster collaboration to create member-centered goals and interventions
• Maintain relationships between support network providers and members
• Increase network provider awareness of CNDC programs
• Reduce acute episodes that need emergency or inpatient care
• Identify social drivers of health and address them by referring members to appropriate resources

National Committee for Quality Assurance

Nine of our CNDC conditions are accredited by the National Committee for Quality Assurance (NCQA) and include outreach, education, care coordination, and follow-up to improve treatment adherence and promote self-care.

Collaborative treatment plans

CNDC invites your input on patient treatment plans. We provide CNDC information and the latest Clinical Practice Guidelines (CPGs) to help you develop an individualized care plan for your patient. The Clinical Practice Guidelines (CPGs) for the chronic conditions mentioned above are accessible on Availity, our secure provider website. CPGs can also be requested at any time.

Care providers can access Total Member View through Availity Essentials to obtain feedback on their patients’ care plans and condition management while enrolled in our program.

Availity 

Contact CNDC

Our CNDC case managers are available from 8:30 a.m. to 5:30 p.m. local time. Confidential voicemail is available 24 hours a day.

Call:  888-830-4300

Email:  Condition-Care-Provider-Referrals@anthem.com

Note: Our CNDC programs do not promote or advertise specific products or services to members or providers. They do not have any financial ownership interests with anyone who advertises, markets, or supplies the goods and services we offer.