Care Management

Care management is “a collaborative process that assesses, plans, implements, coordinates, monitors and evaluates options and services to meet an individual’s health needs through communication and available resources to promote quality, cost effective outcomes” (Care Management Society of America). Aetna Better Health attempts to assist in the efficient utilization of medical resources for members with special health care needs, including highly complex chronic and catastrophic cases to improve access to quality care and avoid unnecessary medical costs.

Members who might benefit from care management are identified for care management through utilization management activities, health risk assessments and screening of administrative data.

Treating providers can refer members for care management services by contacting the Aetna Better Health Medical Management Department at the numbers below. Members can also self-refer for care management.

Medicaid STAR 1-800-248-7767 (Bexar), 1-800-306-8612 (Tarrant)
CHIP or CHIP Perinate 1-866-818-0959 (Bexar), 1-800-245-5380 (Tarrant)