Back to Insights and Updates for ProvidersApril 2024

About Our Chronic Condition Management programs

Harvard Pilgrim Health Care Commercial  |  Harvard Pilgrim Stride (HMO) Medicare Advantage  |  Tufts Health Plan Commercial  |  Tufts Medicare Preferred

Point32Health takes a comprehensive approach to chronic condition management, focusing on patient-centered care that coordinates resources across the health care delivery system and throughout the life cycle of a disease. Point32Health’s chronic condition management programs include a range of components specifically designed to reinforce clinicians’ treatment plans.

These programs assist patients with conditions such as asthma, COPD, heart failure, and diabetes by helping them better understand their condition, giving them new information about their disease, and providing them with assistance from clinical health educators and pharmacists who can help them manage their disease.

Patients identified as having a chronic condition such as diabetes, heart failure, or asthma are enrolled in chronic condition management programs through the following:

  • Referrals by their physicians, case managers, and specialty care providers
  • Medical and pharmacy claims analysis that identifies patients with appropriate diagnoses
  • Self-referral
  • Health risk appraisal

To enroll a Point32Health member into one of our programs, email requests_for_care_management@point32health.org or call 866-750-2068 for Harvard Pilgrim; email Priority_Care_Referrals@point32health.org or call 888-766-9818 ext. 53532 for Tufts Health Plan. In addition:

Members who wish to speak with a care manager can do so by calling the appropriate number below:

  • Tufts Health Plan commercial: 888-766-9818 (TTY: 711), ext. 53532
  • Tufts Health RITogether: 866-738-4116
  • Tufts Health Together and Tufts Health Direct: 888-257-1985

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