Complex Care ManagementThe Tufts Health Priority Care program is designed for members with complex medical needs such as the following:
- Organ transplant
- Multiple sclerosis
- Spinal cord injuries
- Congenital illnesses
- Rare diseases
- Complex medical conditions discharged from a facility
- Other serious conditions
- Telephone support from the dedicated nurse care manager on a schedule complementary to the participant’s needs and availability
- Personalized care plan based on identified goals, evidence-based assessment and the physician’s plan of care
- Educational resources for informed decision making
- Coaching to improve self-management and effective communication with health care providers
- Efficient coordination of care across physicians, health care providers and services
- Access and referral to community resources for financial and social support
- Depression and behavioral health screening
- Caregiver strain screening
Network physicians can directly refer their Tufts Health Freedom Plan patients to the program by calling 888-766-9818, ext. 53532. 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 888-880-8699, ext. 53532. Predictive modeling algorithms based on medical and pharmacy claims and program criteria are also used to identify members.
Learn more, read our Complex Care Management Brochure.