These programs are designed to prevent health problems, such as pregnancy counseling and care management intervention to help to reduce premature labor or low-birth-weight infants. The Health Net care manager works closely with the Health Net health education staff to coordinate in-service education for care management members.

According to Department of Health Care Services (DHCS) contractual requirements, disease care management for Medi-Cal is provided for members with chronic disease conditions such as asthma, Chronic Obstructive Pulmonary Disease (COPD)*, diabetes, and cardiac conditions* (coronary artery disease*, heart failure*, hypertension* or hyperlipidemia*).

The Disease Management/Health Coaching - Be In Charge!^SM program also addresses lifestyle management needs such as exercise*, nutrition, stress*, and weight management**; tobacco cessation** and puff free pregnancy**. For detailed information, see Disease Management Be In Charge Program.

*Denotes adult programs only ** Pediatric weight management program is ages 2 year and above; tobacco cessation programs are ages 12 years and above.

Episodic care management involves treating a specific episode of a member's care that occurs following a specific set of events or diagnoses. Episodic care management usually involves the use of specialists, discharge planners and concurrent review nurses, in addition to the primary care physician (PCP) . Episodic care management is performed by the Health Net Health Services Department, the responsible affiliated health plan's UM department or a participating physician group (PPG) with delegated utilization management functions.