Harvard Pilgrim takes a comprehensive approach to disease management, which focuses on patient-centered care that coordinates resources across the health care delivery system and throughout the life cycle of a disease. Harvard Pilgrim’s disease 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 automatically enrolled in Harvard Pilgrim’s disease management programs through the following:
- Referrals by their physicians, case managers, and specialty care providers
- Census reports from hospital or ER visits
- Medical and pharmacy claims analysis that identifies patients with appropriate diagnoses
- Self referral
- Health risk appraisal
For a full list of all of Harvard Pilgrim’s disease management programs, visit our Disease and Health Risk Management webpage. To enroll a Harvard Pilgrim member into one of our programs, e-mail firstname.lastname@example.org or call 866-750-2068.