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Health Coaching: Programs to enhance the coordination of care for AmeriHealth members with health concerns

August 4, 2020

Your patients may need extra support when managing a chronic condition or complex health situation. Health coaching provides our members, your patients, with an added level of support to help them stay healthy, manage their chronic condition(s), identify emerging risk, follow your treatment plan, and navigate their health journey.

Patient access to AmeriHealth Registered Nurse Health Coaches (Health Coach) and our care management programs enhances your ability to provide coordinated care for your AmeriHealth patients and promotes integration of care among members and their families, physicians, and community resources.

Please review the following updated program descriptions:

  • 24/7 Health Information Line. AmeriHealth members can call anytime to speak with a Health Coach about general health questions and concerns. AmeriHealth New Jersey members can call 1-888-YOUR-AH1 (1-888-968-7241) and AmeriHealth Pennsylvania members can call 1-800-275-2583.

  • AHNJ Wire® Relay Messaging. AmeriHealth members who enroll in AHNJ Wire for health information via email or text, receive outreach messages based on Healthcare Effectiveness Data and Information Set (HEDIS®) gaps, hospital discharge, or general health.* Some messages provide members with the option to call a Health Coach or receive more information from links provided within the message.

  • Case management. Case management provides support to members who are experiencing complex health issues, multiple chronic conditions, transitions in care, or challenges in meeting their health care goals. Complex Case Management services include Health Coaches to educate and support members as well as Social Workers to assist with connections to community resources as appropriate. Enrolled members who participate with AHNJ Wire receive educational messages based on diagnosis and gaps in care.

  • Condition management.Condition management is available to eligible members for specific chronic conditions such as asthma, diabetes, COPD, hypertension, and congestive heart failure. Newly diagnosed members who require support and education (emerging risk) as well as members who have trouble with condition management or exacerbations may benefit from referrals for this service. Eligible enrolled members who participate with AHNJ Wire receive educational messages based on diagnosis and gaps in care.

  • Baby FootSteps® maternity program. Expecting AmeriHealth members can self-enroll in this free program to receive support from an experienced Registered Nurse Health Coach throughout their pregnancy. Please encourage expecting AmeriHealth members to enroll by calling 1-800-598-BABY (1-800-598-2229). Baby FootSteps members receive outreach for screenings to identify high-risk indicators and are offered support for prenatal depression, risk of postpartum depression, and tobacco cessation. Obstetrical Health Coaches provide education and support to expecting AmeriHealth members who have been identified as high-risk throughout the term of her pregnancy.

If you would like to refer a patient, who is an AmeriHealth member, to one of the programs listed above, please complete the online physician referral form for AmeriHealth New Jersey or for AmeriHealth Pennsylvania, or call 1-800-313-8628.

*Standard message and data rates may apply. Text STOP to stop and HELP for help. Terms and Conditions are available at myhelpsite.net/amerihealth. Notification messages within AHNJ Wire are sent via automated SMS. Enrollment in AHNJ Wire is not a requirement to purchase goods and services from AmeriHealth. Wire is a trademark of Relay Network, LLC., an independent company.

AmeriHealth members who are covered through fully insured employer groups are automatically considered eligible for condition management. Members covered through certain self-insured employer groups may not be eligible for the program. AmeriHealth New Jersey members can call 1-888-YOUR-AH1 (1-888-968-7241) and AmeriHealth Pennsylvania members can call 1-800-275-2583 to verify their eligibility.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). Used with permission.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of AmeriHealth, AmeriHealth HMO, Inc., AmeriHealth Insurance Company of New Jersey.
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