Exclusive Care Intensive Health Management Program

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Pathways to Health

Exclusive Care’s Intensive Health Management Program

Pathways to Health Flow Chart

 

 

The Exclusive Care (EC) Pathways to Health (PTH) Program for Intensive Health Management is designed to assist members with advanced obesity.  The assessment appointments as well as the Total Wellness Program are designed to improve management of obesity and related conditions.  Employing these measures will also prepare members for the extensive lifestyle changes that would be required should they undergo bariatric surgery.  Successful completion of the program will greatly decrease the possibility of complications that occur due to the bariatric surgical procedure.

 

The Timeline displays the stages of Pathways to Health and gives an approximate time frame for the completion of each stage.  A description of the stages follows:

 

Step 1. Primary Care Physician (PCP) obtains referral form for the PTH program on the EC page for Referrals.  The PCP is to complete this form and transmit to EC Medical Management.

 

Step 2. EC Medical Management will send the referral to the PTH Patient Services Coordinator for further assessment and review.

 

Step 3. PTH Patient Services Coordinator will contact the member to schedule a Medical Assessment, Psychological Assessment, and Secondary Screening appointment, if all criteria are met for the PTH program. If the member is qualified to continue with the program, the PTH team will submit recommendation to approve the member’s referral to EC Medical Management.

 

Step 4. EC Medical Management will review referral, and if approved, will transmit the approved referral to the PTH Patient Services Coordinator, the PCP, and the member. The PTH Patient Services Coordinator will contact patient and give them an Informational Meeting date and workshop dates.

 

Step 5. The member will attend an Informational Meeting and Physical Activity Consultation. If indicated or recommended, member will attend nutrition consultation as well.

 

Step 6. Upon completion of the Informational Meeting, the member will begin the Total Wellness Program consisting of physical activity, nutrition and psychological support for a minimum duration of 5 months.  Medical stabilization will continue based upon the member’s needs.

 

Step 7. Upon completion of all of the previous steps (1-6), the member will be referred to EAS for a repeat Psychological Evaluation if patient chooses surgery. Member will also be scheduled for Medical Clearance at which a Nutrition and Physical Activity Assessment will also be completed.  

 

Steps 8 & 9.  The Surgical Committee will review the member’s health status, including their current lab reports, progress in the Total Wellness Program, and Psychological Evaluation(s). If all criteria have been satisfied, the member will be referred to the bariatric surgeon. 

 

 

 

Emily Mabee

Patient Services Coordinator

 (951) 955-5576

 

Revised 4/2017