Care Management

Care Management is a program developed by the Centers for Medicare and Medicaid Services (CMS) to help medical practices provide proactive support to patients with chronic or high-risk conditions. Instead of waiting for appointments, this program allows our care team to stay connected with you between visits, ensuring your needs are met and your health stays on track.

At The Urology Group, we recognize how important this ongoing support is for maintaining overall health and improving outcomes. Eligible patients are paired with a dedicated Care Coordinator who works closely with you and your provider to create a comprehensive, individualized care plan. Through regular communication and follow-up, your Care Coordinator helps you stay organized, informed, and supported in every aspect of your care.

Who Is Eligible for Care Management?

You may be eligible if you:

• Have Medicare Part B or a Medicare Advantage/Replacement Plan, or other qualifying insurance (Anthem/Blue Cross Blue Shield, Aetna, Cigna and UnitedHealthcare often participate) and
• Have at least one qualifying chronic or high-risk health condition.

A member of our Care Management team will contact you by phone to explain the program. If you choose to participate, you’ll be assigned a Care Coordinator who will schedule regular check-in calls. Many patients choose monthly calls, but you can select a frequency that fits your needs, every month, every other month, quarterly, or twice a year. Your schedule can be adjusted anytime based on your health or preferences.

Benefits of Care Management

This program gives you a personal Care Coordinator who serves as your advocate and connection between you, your urologist, and the rest of your care team. Benefits include:

• Development of a personalized care plan tailored to your diagnosis and goals
• Improved coordination between your specialists, primary care provider, and pharmacy
• Help with medication reviews, prescription refills, and treatment questions
• Support in scheduling appointments, tests, and follow-up visits
• Assistance in connecting with support services and community resources
• Focus on preventing unnecessary ER visits or hospital readmissions

Your Care Coordinator will keep in touch regularly to monitor your progress, answer questions, and ensure that your care stays on course.

Nutrition Services

At The Urology Group, we believe that good nutrition is an essential part of good health. As part of our Care Management Program, our Nutrition Team provides personalized guidance to help patients make smart, sustainable choices that support their urologic and overall wellness.

Our registered dietitians specialize in the nutritional needs of patients with urologic conditions. They work closely with your physician and care team to create practical, individualized plans that can help you:

• Prevent kidney stones through customized hydration and dietary recommendations
• Support prostate health and overall metabolic balance
• Reduce overactive bladder symptoms by identifying and minimizing dietary triggers
• Maintain energy, strength, and healing during and after cancer treatment
• Nutrition support to aid in surgical recovery

Whether your goal is prevention, symptom management, or recovery, our nutrition experts are here to help you take charge of your health, one meal at a time.

Chronic and High-Risk Conditions

The Centers for Disease Control and Prevention (CDC) defines a chronic condition as one lasting longer than a year, requiring ongoing medical attention, or limiting daily activities such as eating, bathing, dressing, or mobility.

Common Urologic Chronic Conditions:

• Benign Prostatic Hyperplasia (BPH or enlarged prostate)
• Overactive Bladder
• Recurrent Urinary Tract Infections
• Bladder Cancer
• Kidney (Renal) Cancer
• Prostate Cancer
• Ureter Cancer
• Renal Pelvis Cancer

Other Chronic and High-Risk Conditions Recognized by CMS (partial list):

Alzheimer’s disease and dementia, arthritis, asthma, atrial fibrillation, autism spectrum disorders, cancer, chronic kidney disease, COPD, depression, diabetes, heart failure, hepatitis B & C, HIV/AIDS, high cholesterol, high blood pressure, ischemic heart disease, osteoporosis, schizophrenia, and stroke.

Insurance Coverage

Care Management is covered under Medicare and many other insurance plans. If you have Medicare with secondary insurance, the service may be fully covered. Like other healthcare services, participation is subject to your plan’s deductible, coinsurance, or copay depending on your specific benefits.

To learn more or enroll in our Care Management program, call The Urology Group at (703) 724-1195 and select Care Management, or reach our Care Management team directly at (703) 936-2922.