Commercial Preferred Provider Organization
NCQA is governed by a Board of Directors that includes employers, consumer and labor representatives, health plans, quality experts, policy makers and representatives from organized medicine.
ODS Disease Management Programs
ODS Disease Management programs are offered to ODS medical plan members. Our health coaching team provides individualized interventions for patients coping with chronic medical conditions. Health coaches help these patients follow their providers care plans, answering their health care questions and empowering them to take a central role in managing their care. All programs are based on national clinical guidelines.
ODS members eligible for these programs are identified through claims analysis, physician referral or self-referral. These programs are completely voluntary and comply with all federal and state regulations, including the Health Insurance Portability and Accountability Act (HIPAA).
ODS notifies Provider’s when their patients enroll in one of the disease management programs. Provider’s are asked if ODS can offer additional assistance with co-morbid conditions in order to help their patients’ achieve optimal health status. ODS also provides chart-ready follow up reports on each patient.
Conditions covered through disease management coaching programs:
If you would like to refer a patient to ODS for disease management, please contact us at:
- Portland/metro 503-948-5548
- Toll-free: 877-277-7281
- TTY number (for the hearing and speech-impaired): 800-433-6313
- E-mail:
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.
- 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.
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 Customer Service using the phone number printed on the back of the member's identification card.
Clinical tools
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.
Obesity
ODS encourages all providers to screen for obesity using validated tool such as: