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ODS Disease Management/Health Coaching Programs
ODS Health Coaching programs are offered to ODS medical plan members. Our health coaching team provides individualized interventions for patients coping with chronic medical conditions. Health coaches help these patients follow their providers care plans, answering their health care questions and empowering them to take a central role in managing their care. All programs are based on national clinical guidelines.
ODS members eligible for these programs are identified through claims analysis, physician referral or self-referral. These programs are completely voluntary and comply with all federal and state regulations, including the Health Insurance Portability and Accountability Act (HIPAA).
ODS notifies Provider’s when their patients enroll in one of the Health Coaching programs. Provider’s are asked if ODS can offer additional assistance with co-morbid conditions in order to help their patients’ achieve optimal health status. ODS also provides chart-ready follow up reports on each patient.
Conditions covered through disease management coaching programs:
- Asthma
- Back and Joint Pain
- Chronic Obstructive Pulmonary Disease
- Cardiovascular Risk Factors
- Depression
- Diabetes
- Lifestyle Coaching
- Maternity
If you would like to refer a ODS patient for health coaching, please contact us at:
- Portland/metro 503-948-5548
- Toll-free: 877-277-7281
- TTY number (for the hearing and speech-impaired): 800-433-6313
- E-mail:
Patient Activation Measures
ODS staff is trained in the use of motivational interviewing techniques – informed by the insight gained from the Patient Activation Measures (PAM) tool – which allows them to focus on helping participants develop confidence in managing their health (depending on their activation level) rather than on encouraging behaviors they may not be ready to achieve.
PAM is a dynamic assessment and coaching tool that assesses an individual’s knowledge, skills and confidence around managing their health and healthcare. The measure is used at the individual member level to tailor interventions and to serve as the outcome measure to assess change, and track the shift from lower to higher levels of activation. The data shows that small increases in activation have significant impacts on medication adherence, treatment compliance, reductions in ER utilization and acute care readmissions.
Based on responses to the survey, each member is assigned an activation score and level. By understanding participants’ “activation levels” ODS staff can better tailor coaching to the individual’s level of activation, helping them identify and overcome barriers. The behaviors encouraged for each activation level are based on empirical data indicating what is realistic at a particular level.Clinical guidelines
The guidelines below are not intended to direct clinical care in any specific circumstances. They are intended to communicate either evidence-based or generally accepted approaches to care.
- The National Heart Lung and Blood Institute (NHLBI) guidelines for the management of High Blood Pressure (JNC7) and Clinical Guidelines on Cholesterol Management in Adults (ATPIII)
- The American Diabetes Association (ADA) guidelines for the management of diabetes mellitus
- Global Strategy for Asthma Management and Prevention
- Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease
- The NHLBI guidelines for diagnosis and long term management of asthma
- Institute for Clinical Systems Improvement guideline for treatment of major depression in adults in primary care
- The National Institutes of Health’s Guidelines for the Identification, Evaluation and Treatment of Overweight and Obesity in Adults
- The American College of Obstetrics and Gynecology supports Center for Disease Control (CDC) Guidelines for screening for known risk factors or all women who are planning a pregnancy
- The Institute for Clinical Systems Improvement (ICSI) guideline for Low Back Pain, Adult
- The Institute for Clinical Systems Improvement (ICSI) guideline for Pain, Chronic, Assessment and Management of
- American Academy of Orthopedic Surgeons for treatment of Osteoarthritis of the knee (non-arthosplasty)
- The ICSI Diagnosis and Treatment of Adult Degenerative Joint Disease
- CDC Advisory Committee on Immunization Practice
- AHRQ/US Preventive Services Task Force Guide to Clinical Preventive Services
- Tobacco Cessation Clinical Guidelines United States Preventive Taskforce (USPTF)
All guidelines can be obtained from the National Guidelines Clearinghouse.
Clinical practice guidelines may include treatment that is not covered by a member's ODS benefits. Benefit information can be obtained by calling Customer Service using the phone number printed on the back of the member's identification card.
Clinical tools
Obesity
ODS encourages all providers to screen for obesity using validated tool such as:
Preconception & Maternity
ODS encourages all providers to offer preconception counseling to women who are activity attempting or planning pregnancy. Below are recommended tools to use with patients.
Breastfeeding
Breastfeeding is a major decision for every expectant mother. Our resources will help you prepare and be successful with breastfeeding.
Asthma and pregnancy
Managing a chronic illness such as asthma during pregnancy can be difficult and confusing. Our resources help you identify triggers and timing as well as help you manage your symptoms.
Ovulation calculator
Use this tool to calculate the days you are most likely to get pregnant.
Before You Get Pregnant
A healthy pregnancy begins before you become pregnant. Take a moment to learn what you can do now to make sure any future pregnancies are planned and healthy.
Pregnancy quiz
This quiz will test your knowledge and understanding of how to achieve a healthy pregnancy.