QCARE health and wellness programs offer tools to help you stay healthy or manage a chronic illness. This means improved health and lower health care costs. Programs are led by an in-house Medical Director and a team of registered nurses.

One-on-One Health Coaching

Lower or control your out-of-pocket costs by changing your habits. Since two thirds of all health care costs are linked to poor health behaviors, this is a smart plan! Our health coaches teach members to set and reach health and well-being goals. They also give support and education on issues like:

  • Stopping tobacco use
  • Improving diet
  • Handling stress
  • Increasing activities 
blood glucose testing

Complex & Long-Term Illness

QualChoice registered nurses can help you deal with complex diseases and long-term health issues. We offer programs for:

  • Asthma
  • Cancer
  • Congestive heart failure
  • High blood sugar
  • High-risk pregnancy
  • High blood pressure
  • Organ transplant

A trained nurse care manager serves as the single contact to ensure that you get the support you need. Training and guidance are provided even for multiple conditions. 

Online Member Support

  • Learn what to ask your doctor.
  • Find and compare hospitals.
  • Browse a library of health topics.
  • Link to extra help with health care decisions.
  • Get a current health assessment.

Sign in to My Account to learn more.

Health and Wellness Programs Overview

 

CARES Cancer Awareness

CARES, our Cancer Awareness Resources and Support program, helps members understand their condition. It also helps them to take an active role in managing their treatment.*

Registered nurse care managers work with members one-on-one to:

  • Get ready for doctor visits
  • Ask the right questions when seeing their doctor
  • Take an active role in their care and treatment
  • Answer any questions that may come up

Our care managers stress the value of:

  • Checking body temperature
  • Drinking enough fluids
  • Tracking weight
  • Following a high-protein eating plan
  • Keeping up an appetite
  • Getting enough exercise to build red blood cells

Cancer Awareness Program Overview

Diabetes Management

Our Diabetes Management Program provides extra care for members living with diabetes. Eligible members and dependents can take part at no added cost as part of their QualChoice benefits.*

Our registered nurse health coaches give personal support to help members manage their diabetes. This helps reduce related problems and improve their quality of life. Benefits include:

  • Support of health coaches
  • Tips on managing health
  • Lower out-of-pocket costs
  • Consistent, quality care

Risk Factors

  • Over 45 years old
  • Family history of diabetes
  • BMI of 25 or more
  • Inactive
  • African-American, Latino, Native-American, or Pacific-Islander
  • Blood pressure 140 over 90 or higher
  • HDL (good) cholesterol of 35 or lower
  • Triglycerides 250 or higher
  • Impaired fasting glucose (between 110 and 125)
  • Had gestational diabetes or gave birth to a baby weighing 9 pounds or more
  • Polycystic ovary syndrome

Diabetes Management Program Overview

Diabetes Management Program Overview-ES

Heart Health

Our Healthy Heart Program uses evidence-based, nationally accepted practices and a personalized approach to assist members living with hypertension.*

About 50 million Americans — one in three adults — live with hypertension (high blood pressure). We offer a complete, multi-pronged program for treating hypertension.

QualChoice members age 18 or older may enroll free of charge. The program offers support for members to reach their health care goals and follow their doctor’s treatment plan. Participating members also receive a complimentary blood pressure monitoring kit.

Enrolled members receive periodic calls from a QualChoice registered nurse health coach to discuss:

  • Signs and symptoms
  • Medications and medication schedules
  • Importance of a low-sodium (salt) diet
  • Doctor appointments
  • Preventing hospital admissions
  • Monitoring and recording blood pressure

Heart Health Program Overview

Heart Health Program Overview-ES

Maternity Management

Our Special Additions Maternity Program, combined with prenatal care from a doctor, helps members enjoy a healthy pregnancy and deliver a healthy newborn.*

A Special Additions nurse acts as an advisor and guide, coaching the member and sharing information.

Our maternity care manager will:

  • Review the member's health history, diet and exercise
  • Spot and assess potential risks
  • Suggest ways to lessen risks for mother and baby
  • Share information on pregnancy, childcare, labor and delivery
  • Work with the doctor to coordinate care
  • Point the member toward community resources

Maternity Management Program Overview

Post-Discharge Care

Studies show that many patients forget most of what they’ve been told by the time they get home! This can lead to new medical problems. Our Post-Discharge Outreach* program helps make sure our members’ health care needs are met even after they leave the hospital. 

With the Post-Discharge Outreach program, our care managers can:

  • Reduce member anxiety
  • Help the member understand and follow their discharge plan
  • Help communicate with the doctor
  • Spot potential problems 

To reduce repeat hospital stays, we target members who may be at risk and call them after they leave the hospital. Those at risk include patients with a complex discharge plan, past repeat stays, or frequent emergency use.

Post-Discharge Care Program Overview

Stopping Tobacco Use

To support our members’ efforts to quit tobacco use, QualChoice offers a free 12-week Kick the Nic! program, available to all new and renewing QualChoice members.*

What Does the Program Include?

  • The services of a health coach trained in tobacco cessation
  • Voucher for two free doctor visits with no co-payment
  • Voucher for free smoking cessation medication (Chantix ®) if prescribed
  • Voucher for nicotine replacement therapy if prescribed

A report from the Surgeon General's office showed that after 6 months, 33% of smokers using smoking cessation medication had succeeded in quitting. Kic the Nic! has shown an even better rate at 39%!

Tobacco Cessation Program Overview

Tobacco Cessation Program Overview-ES

Transplant Care

Each step in the organ transplant process calls for special attention and team care. Our QCARE nurse care managers arrange all services before, during and after the procedure.

Registered nurse care managers support members throughout the process by:

  • Coaching the member and their family through a complex procedure
  • Setting goals for the member each step of the way
  • Easing fears while waiting for the transplant
  • Sharing helpful resources, tips and support after the transplant
  • Working with the healthcare team to make sure the member follows their care plan

To make sure our members get the best care, we cover only transplants done at centers recognized nationwide for their number of transplants and successful results.

Transplant Care Program Overview


NOTE: Programs vary by employer group and benefit plan. Members should check with their benefits administrator.

Contact a QCARE health coach today to learn more or enroll. 
Call 501.228.7111 or 800.235.7111

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