Disease Management Program Chart

Health New England currently has three disease management programs in place. The following chart gives a high level overview of each program and provides a contact person for each program. If you have any questions or wish to refer a member to one of the programs, please call the contact person listed.

HNEHNE	Brighter Infant Beginnings Program	Diabetes Management Program	Asthma Management Program
Program Goal	Provision of a core set of educational materials and services to all pregnant HNE members. Identify and manage all possibly high risk pregnancies as early as possible.	Identify all HNE members with diabetes mellitus. Based upon members risk status, educational and/or case management services are provided.	To improve the medical care and self-care management of adult patients with asthma through the provision of educational materials and peak flow meters.
Target Population	All HNE members who are pregnant.	All HNE members with Type 1 or 2 diabetes in Hampden, Hampshire and Franklin Counties.	All HNE members, 18 years and older, that have had either 2 office visits, 1 ER visit and/or 1 hospitalization with a primary diagnosis of asthma.
Implementation	Prenatal Registration Form is provided to HNE by obstetrical office after the first prenatal visit. The form is reviewed to identify potential high risk patients. Providers are notified of members assessed and followed (case managed) as high risk. All members are sent a package of educational materials. An authorization for services is generated.	Members are confirmed as having diabetes and then stratified based upon risk factors. Three Risk Levels: I-patient is under good control per physician II-patient is not under good control per physician. Member that has low intensity health care needs of long duration. Member that has high intensity health care needs of short duration. III -patient is not under control as per risk assessment of physician. Member that has high intensity health care needs of unknown or extended duration. All confirmed members receive a packet of educational materials. Additional educational interventions include: Basic Diabetes Education Class, Nutrition/Meal Planning Education Class, RN Assessment, Toll Free Diabetes Information Line and Case Management Services. Members receive a letter introducing the program with a survey to complete and return.	Members receive a letter introducing the program with a survey to complete and return. Upon receipt of the survey a packet of educational materials is mailed. Educational materials focus on asthma management, self-care and the proper use of a peak flow meter. Provision of a peak flow meter to those members in need of one.
Program Implementation	April 1998	July 1998	February 1999
Contact Person	Donna Stafilarakis, RN 413-787-4000, ext. 3391	Lynn Ostrowski 413-787-4000, ext. 3383	Krista O’Shea 413-787-4000, ext. 3327