Disease Management Programs Designed to Control Costs
and Improve Health Outcomes

Tufts Health Plan offers disease management services for members.

Conditions Targeted
Tufts Health Plan's disease management program helps support member education, with the goal of empowering members to better manage their health care and optimize their overall health status.

Participants in the program receive customized educational materials, personalized health evaluations, and depression screening.

• Five chronic conditions are targeted: diabetes, heart failure, asthma, chronic obstructive pulmonary disease, and coronary artery disease
  
  
• Four impact conditions are also targeted: acid-related stomach disorders, atrial fibrillation, osteoarthritis, and low back pain

Registered nurses work with members to educate them and support appropriate access to available health care resources.

How Members are Referred to the Program
We identify members who might benefit from the program through medical claims and pharmaceutical data, physician referrals, and case management referrals.

Eligible members receive a letter describing the program and a follow-up phone call to discuss participation.

Enhancing Patient Understanding, Compliance
This program is aimed at enhancing patients’ understanding of their illness through ongoing education and support. It encourages members to take an active role in managing their condition and to adhere to their physician’s prescribed treatment plan.

The program is included for fully-insured employer groups, and available as an option for self-insured employer groups.