Care Management Resources

In 2017 the combination of our team of highly skilled health care professionals and robust care and disease management programs achieved a 32% reduction in total medical expense after just six months for enrolled members.

Our Team

All members have access to health care professionals who are certified care managers, wellness coaches, licensed social and behavioral health workers, and nurse educators specializing in diabetes, pediatrics, asthma and cardiology.

What sets our team apart is a distinct “whole person” approach that goes beyond just medical needs—they consider behavioral, pharmacy, health and wellness, and socio-economic needs too.

Our team reaches out to members when and how it’s best for them—at home, work or on the road—whether by phone, email or mobile applications.

By building personal connections and trusted relationships our team guides members to better health, reduced risk and lower costs.

Since 2017, 85% of the members we reached engaged with us,
a powerful validation of how we work.

Our Programs

All Harvard Pilgrim plans, whether fully or self-insured, include our industry-leading programs aimed at supporting members wherever they are in the continuum of health—at no additional cost.

Our programs range from helping members living with conditions such as asthma, diabetes, heart disease and COPD—to those at risk for hospitalization due to multiple conditions and diagnoses—to those who could benefit from lifestyle support programs, such as pregnancy, smoking cessation, nutrition and weight management.

Provider Partnerships

Our value-based provider contracts and deep partnerships also drive better health and deliver greater value. Our team of health care professionals work together with the member’s primary care provider to connect them to programs and services to put them on a path to better health.

80% of MA provider groups have value-based contracts with us.
Adjusted medical costs trends are 4% lower for providers in value-based contracts than those who are not.

Learn More

Contact your Account Executive for more information about our Care Management Programs.