Integrated Care Management

Tufts Health Public Plans

Care management is everything we do to help you keep your Tufts Health Plan patients well and improve their health.

We help your patients make and keep appointments, coordinate their care, give you information about them and help you get the authorization you need when you need it.

Through our integrated care management services, we use health risk assessment tools, clinical practice guidelines, and other care management tools to:

• Wellness initatives
• Disease management programs
  • Asthma
  • Diabetes
  • HIV/AIDS

• Utilization management (UM) review (care coordination)
• Behavioral health (and/or substance abuse) care services
• Our integrated care management team can help your patients through:
  • Complex care management
  • Behavioral health intensive clinical management
  • Social care management

Contracting providers can directly refer their Tufts Health Plan patients to the program by calling 888.257.1985. A nurse care manager will contact the member to discuss his or her needs and interest in the program.

Members who wish to enroll may also self-refer to the program by calling 888.257.1985. Data based on medical and pharmacy claims and programs standards are also used to identify members.