Convergence Population Health Management

Your Health Is Our Priority

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Convergence Population Health Management is a proactive, virtual care model.

The program is designed for individuals with chronic health conditions such as diabetes, hypertension, high cholesterol, or congestive heart failure. Our world-class team of providers use Optimal Medical Therapy, a unique approach to care management, to provide the highest quality of care, improving health and lowering care plan costs.

 

Goals of Optimal Medical Therapy

Symptom Relief: Reduce or eliminate symptoms like chest pain, shortness of breath, and fatigue.

Improvement in Quality of Life: Enhance the daily functioning and overall well-being of patients.

Prevention of Disease Progression: Slow or halt the progression of the underlying disease.

Reduction in Morbidity and Mortality: Decrease the incidence of complications, hospitalizations, and death related to the disease.

Optimization of Health Outcomes: Achieve the best possible health outcomes through personalized treatment plans.

Key Components of Optimal Medical Therapy

Medications: Utilization of evidence-based medications such as angiotensin receptor blockers (ARBs, ACE inhibitors, statins, antiplatelet agents, and others as indicated by specific guidelines).

Lifestyle Modifications: Recommendations for a heart-healthy diet, regular physical activity, smoking cessation, weight management, and stress reduction.

Monitoring and Follow-up: Regular monitoring of the patient's condition and medication adherence, with adjustments to therapy as needed.

Patient Education and Engagement: Ensuring patients understand their condition, the importance of adherence to their treatment plan, and how to manage their symptoms.

 
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The Population Health Management Process

Convergence Population Health Management offers a variety of services to support individuals in managing their health and well-being.

Initial Contact

Individuals can contact Convergence Population Health Management by phone or email to inquire about our services or to receive assistance.

Enrollment

Upon contact, an initial consultation will be scheduled where a Population Health Management (PHM) nurse or a representative will explain the services and assist with the enrollment process.

Service Utilization

Once enrolled, individuals will receive information on how to access and utilize the specific services they are eligible for, including any scheduled appointments, health management plans, and available resources.

 

 

How Do I Know If I Am Eligible?

Individuals become eligible to participate in Convergence Population Health Management’s programs through the following means:

  • Claims and Pharmacy Data: Eligibility is determined based on the review of medical and pharmacy claims data.

  • Eligible Individual List from Client Organizations: Lists provided by client organizations that identify eligible individuals.

  • Information Collected from Individuals, Practitioners, and Client Organizations: Direct information gathered during consultations or from medical practitioners and associated client organizations.

Have Questions?

Convergence Population Health Management operates from 9:00 AM to 6:00 PM CST

Phone: 833.483.2997

Email: concerns@convergenceth.com

In urgent situations, individuals should contact the phone number or email listed above.

 

For More Information

 
 

 Our Team

 

 

William H. Bestermann Jr., MD

Medical Director

William H. Bestermann Jr., MD is a board-certified internist who practiced preventive cardiology for 20 years. He has been heavily involved with health care reform and quality improvement for over a decade.  He wrote the first article on a systematic approach to the metabolic syndrome. He led an advanced cardiometabolic medical home that managed high risk diabetic and hypertensive patients for a Fortune 100 company in Tennessee. He was a Senior Clinical Advisor for the Quality Blue Primary Care program at Blue Cross Blue Shield of Louisiana. That initiative saved $27 pmpm net at the 1-year mark while reducing hospitalizations, length of stay, and specialty referrals. He is currently a senior clinical advisor for Congruity Health, and he consults with healthcare organizations to help them produce optimal medical therapy (OMT) for cardiovascular and related conditions more consistently.

 

Susan Plante

Population Health Registered Nurse

Susan is a registered nurse with 26 years of experience working in multiple areas of nursing, from acute care to quality management. More recently, in the past 8 years, Susan has been working with clients managing chronic health conditions as an RN health coach, primarily over the phone and email. Susan has found that working collaboratively with her clients to build therapeutic relationships is the key to sustainable healthy change; resulting in health improvements for those managing chronic health conditions.

Suzanne Keller

Population Health Registered Nurse

Suzanne has 26 years of experience as a registered nurse in multiple adult critical care roles. As well as functioning as the charge nurse and team leader of the code blue team, Suzanne has worked for two large insurance companies as a case manager, in the hospital as a hospital inpatient case manager. Most recently, she has worked as a telehealth nurse, engaging patients with chronic health conditions using optimal Medical Therapy regimens to assist patients who were recently diagnosed with congestive heart failure, diabetes, and hypertension to improve health outcomes.

 
 
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Member Rights

As a member of Convergence Population Health Management Optimal Medical Therapy program you have the right to:

  • Decline participation in or dis-enroll from programs and services offered by the organization.

  • Know which staff are responsible for managing their services and from whom to request a change.

  • Be supported by the organization to make health care decisions interactively with their practitioners.

  • Be informed of all treatment options included or mentioned in clinical guidelines, even if a treatment is not covered, and to discuss options with treating practitioners.

  • Have personal identifiable data and medical information kept confidential; know what entities have access to their information; know procedures used by the organization to ensure security, privacy and confidentiality.

  • Be treated courteously and respectfully by the organization’s staff.

  • Communicate complaints to the organization and receive instructions on how to use the complaint process, including the organization’s standards of timeliness for responding to and resolving issues of quality and complaints.

  • Receive understandable information that is cultural and linguistically appropriate.

 

Complaints

If you experienced any issues or would like to discuss concerns with the program or staff, please leave a message at 833.483.2997 and we will respond within 48 business hours.

Individuals can communicate complaints or provide feedback via email to concerns@convergenceth.com.

Opting In and Out

Opting In: Individuals agree to participate during the initial contact or any subsequent communication with our representatives.

Opting Out: Individuals must inform the initial contact person or any Convergence Population Health Management representative that they would like to discontinue participation and request the removal of their information for future calls.

Convergence Population Health Management follows NCQA’s expectations of notifying individuals that information is available on its website.