Disease Management Centralized Care Unit

Our Disease Management Centralized Care Unit (DMCCU) is based on a system of coordinated care management interventions and communications designed to assist physicians and others in managing members with chronic conditions.

DMCCU mission

The mission of the DMCCU department is to improve the health and quality of life for the members served by encouraging member self-care efforts, coordinating health care education and providing interventions along the Continuum of Care.

DMCCU services include:

  • A holistic, member-centric approach to disease management focusing on the needs of the member.
  • Motivational interviewing techniques used in conjunction with member self-empowerment.
  • Disease Management programs for asthma, bipolar disorder, coronary artery disease (CAD), congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, HIV/AIDS, hypertension, major depressive disorder (MDD), child and adolescent MDD, schizophrenia and substance use disorder (SUD).
  • Nine of our Disease Management programs are National Committee for Quality Assurance accredited and incorporate outreach, education, care coordination and follow-up to improve treatment compliance and enhance self-care.
  • The ability to manage more than one disease to meet the changing health care need of our member population.
  • Weight management and smoking cessation services.

Our programs feature:

  • Proactive population identification processes.
  • Chronic disease care gaps identification.
  • Evidence-based national practice guidelines.
  • Collaborative Practice Models to include physician and support-service providers in treatment planning for members.
  • Continuous patient self-management education including primary prevention, coaching related to healthy behavior and compliance/surveillance as well as case/care management for high-risk members.
  • Process and outcomes measurement as well as evaluation and management.
  • Ongoing communication with providers regarding patient status.

Disease Management Programs are designed to:

  • Address gaps in care.
  • Improve the understanding of disease processes.
  • Improve the quality of life for our members.
  • Collaborate to develop member-centered goals and interventions.
  • Support relationships between member and network providers.
  • Increase network provider awareness of Disease Management Programs.
  • Reduce acute episodes requiring emergent or inpatient care.

Note, DMCCU does not advertise, market or promote specific products or services to members or providers. We do not have any financial ownership arrangements with anyone who advertises, markets or provide the goods and services we offer.

Who is eligible?

Anthem members who have been diagnosed with the above conditions and are identified through continuous case finding efforts including continuous case finding welcome calls, claims mining and referrals are eligible for Disease Management services.

How can you use DMCCU services?

  • Maximize your time.
    As a valued provider, we encourage you to refer your patients with the following conditions to Disease Management: asthma, bipolar disorder, CAD, CHF, COPD, diabetes, HIV/AIDS, hypertension, MDD, child and adolescent MDD, schizophrenia or SUD. In addition, refer patients who could benefit from additional education or care management.
  • Get help with treatment plans.
    In order to assist in managing patients, Disease Management requests your input for patient care plans. Disease management information and the most up to date Clinical Practice Guidelines are provided to assist you in creating a treatment plan.
  • Receive feedback on your patients.
    Providers can access Patient360 to obtain feedback on their members regarding their care plans and condition management while enrolled in disease management.

Provider rights and responsibilities:

You (as well as your Anthem patients enrolled in a DMCCU program) have additional rights and responsibilities, such as the right to:

  • Receive information about DMCCU, including programs and services, our staff and their qualifications, and any contractual relationships.
  • Decline to participate in or work with disease management programs and services for our members, if contractually possible.

As a participating provider, you will be informed on how DMCCU coordinates disease management-related interventions with treatment plans for our members. This includes:

  • Knowing how to contact the person responsible for managing and communicating with your Anthem patients.
  • Being supported by DMCCU to make decisions interactively with your Anthem patients regarding their health care.
  • Receiving courteous and respectful treatment from DMCCU staff.
  • Communicating complaints to DMCCU regarding disease management as outlined in the Provider Complaint and Grievance Procedure.

These rights and responsibilities are available in written format upon request to DMCCU by calling 1-888-830-4300

* CPG’s are available to our providers on our secure provider website (login is required). They also can be faxed to providers at any time upon request

How can you contact us?

DMCCU case managers are registered nurses and are available from 8:30 a.m. to 5:30 p.m. local time Monday through Friday. Confidential voicemail is available 24/7. The Help Line is also available 24/7 for our members.