Our Programs

Our goal is to provide you with the best care possible and to minimize costs and inconvenience to you. We know your time and your health is valuable.

Chronic Care Management Program

To Qualify, Patients Must:

Have multiple (two or more) chronic conditions expected to last at least 12 months.

Chronic conditions in that place the patient at significant risk of functional decline.

The Program Includes:

Comprehensive plan of care established, implemented, and continuously monitored by a Nurse Practitioner.

Outline of areas of focus/improvement, expected outcome, and prognosis.

Measurable treatment goals and symptom management.

Examples of Chronic Conditions Include:

• Alzheimer’s Disease

• Cancer

• Diabetes

• Autism

• Hypertension

• Cardiovascular Disease

• Arthritis

• Depression

• Infectious Diseases

• COPD

• Atrial Fibrillation

• HIV / AIDS

Diabetic Management Program

What to Expect:

Personalized, in-home education and materials

Clinical guidance for disease management and outcomes measurement

Physical assessment

Medication consultation and guidance

How Can it Help:

Lower A1C levels

Reduction in hospitalizations

Improved quality of life

Prevent or reduce diabetes complications

Benefits of the Program:

A coordinated approach to care

Nurse Practitioner oversight

Hospitalization readmission reduction

Clinic appointment compliance