ODS. Healthcare from your head to your toes.

Healthcare services

Health conditions can be challenging. That's why we offer a variety of specialized care programs designed to help members get one-on-one attention from an ODS health coach who provides customized guidance.

ODS members have access to care programs that help them manage medical conditions:

Health Coaching Programs. This flyer provides a summary of the care programs offered to ODS members.
Health Coaching FAQ. This flyer provides answers to frequently asked questions about the ODS care programs.
Cardiac Care. Members enrolled in the Cardiac Care Program take a personal risk assessment that aids the health coach in managing specific conditions.
Diabetes Care. Health coaches help reduce the complications associated with diabetes, set and achieve goals, and track progress toward improved health.
Depression Care. Health coaches guide members through self-awareness and better management of depression symptoms.
Respiratory Care. Health coaches work with members to identify asthma triggers, set goals, track progress and help provide the support needed to feel better and breathe easier.
Maternity Care. Expectant mothers get the support and information they need both during and after pregnancy. Specialized guidance is available to members experiencing a high-risk pregnancy.
Spine & Joint Care. Coaches create a plan of modified or joint-sparing activities and techniques to use at home or work. We partner with members as they work with you, their providers, on stretching and strengthening exercises, relaxation techniques, and management of their diet, weight and medication.
Lifestyle Coaching. Our health coaches work with members on a number of topics including nutrition, stress, sleep, physical activity and more.
Weight Management Our health coaches will work with members to help them control their weight and track their progress to better health. (This plan is not available to all members; members should refer to their Member Handbook for specific plan benefits.)

Participants in ODS care programs will:

Work one-on-one with a trained health coach over the phone or via e-mail
Set goals and learn how to achieve them
Learn how to effectively manage their conditions
Receive educational materials, answers to questions and self-management tools
Track progress to better health
Receive incentives for participation
Receive mailings with screening reminders, health education and information about medications

Patient Activation Measures

ODS staff is trained in the use of motivational interviewing techniques – informed by the insight gained from the Patient Activation Measures (PAM) tool – which allows them to focus on helping participants develop confidence in managing their health (depending on their activation level) rather than on encouraging behaviors they may not be ready to achieve.

PAM is a dynamic assessment and coaching tool that assesses an individual’s knowledge, skills and confidence around managing their health and healthcare. The measure is used at the individual member level to tailor interventions and to serve as the outcome measure to assess change, and track the shift from lower to higher levels of activation. The data shows that small increases in activation have significant impacts on medication adherence, treatment compliance, reductions in ER utilization and acute care readmissions.

Based on responses to the survey, each member is assigned an activation score and level. By understanding participants’ “activation levels” ODS staff can better tailor coaching to the individual’s level of activation, helping them identify and overcome barriers. The behaviors encouraged for each activation level are based on empirical data indicating what is realistic at a particular level.

Clinical guidelines

The guidelines below are not intended to direct clinical care in any specific circumstances. They are intended to communicate either evidence-based or generally accepted approaches to care. These clinical guidelines are available for download.

The National Heart Lung and Blood Institute (NHLBI) guidelines for the management of High Blood Pressure (JNC7) and Clinical Guidelines on Cholesterol Management in Adults (ATPIII)
The American Diabetes Association (ADA) guidelines for the management of diabetes mellitus
The NHLBI guidelines for diagnosis and long term management of asthma
Institute for Clinical Systems Improvement guideline for treatment of major depression in adults in primary care
The National Institutes of Health’s Guidelines for the Identification, Evaluation and Treatment of Overweight and Obesity in Adults
The American College of Obstetrics and Gynecology supports Center for Disease Control (CDC) Guidelines for screening for known risk factors or all women who are planning a pregnancy
The Institute for Clinical Systems Improvement (ICSI) guideline for Low Back Pain, Adult
The Institute for Clinical Systems Improvement (ICSI) guideline for Pain, Chronic, Assessment and Management of
American Academy of Orthopedic Surgeons for treatment of Osteoarthritis of the knee (non-arthosplasty)
The ICSI Diagnosis and Treatment of Adult Degenerative Joint Disease
CDC Advisory Committee on Immunization Practice
AHRQ/US Preventive Services Task Force Guide to Clinical Preventive Services
Tobacco Cessation Clinical Guidelines United States Preventive Taskforce (USPTF)

All guidelines can be obtained from the National Guidelines Clearinghouse.

Clinical practice guidelines may include treatment that is not covered by a member's ODS benefits. Benefit information can be obtained by calling ODS Customer Service using the phone number printed on the back of the member's identification card.

Clinical tools

Obesity

ODS encourages all providers to screen for obesity using validated tool such as:

ODS would like your support for our Weight Management health coaching program. In an effort to address and combat overweight and obesity, we have begun to identify obese and overweight members based on medical ICD-9 codes included on medical claims. Based on our claims search, we tailor educational outreach to members and refer them to health tools and resources.

When billing for a routine health exam or physical, which includes a screening and assessment of your patient's body mass index (BMI), please include ICD-9 medical codes V85.00–V85.54 (body mass index descriptors¹) as well as medical code 278.00 (overweight and obesity¹) as ancillary ICD-9 codes.

¹Source: ICD-9-CM Volumes 1 through 3, American Academy of Professional Coders, 2010

Preconception and maternity

ODS encourages all providers to offer preconception counseling to women who are actively attempting or planning pregnancy. Below are recommended tools to use with patients.

Reproductive life plan

Asthma and pregnancy

Managing a chronic illness such as asthma during pregnancy can be difficult and confusing. Our asthma and pregnancy flyer help women identify triggers and timing as well as help them manage their symptoms.

Preconception

There are many reliable online tools available to women who are trying to get pregnant. Some examples of these tools include ovulation calculators, steps women can take to ensure a healthy pregnancy and a pregnancy quiz to test a women’s knowledge. Many of these tools are available to ODS members in their myODS account. If you have a patient who is actively trying to get pregnant, refer them to the ODS Maternity Care section of myODS. Members can access myODS by visiting www.odscompanies.com/members.