Chronic Disease Pledge Bright Spot: Health New England Tailored Care Management

December 11, 2024

ACHP member Health New England has a new approach to diabetes care, and it is “a game-changer.”

The program improves care for individuals with diabetes who also struggle with severe mental illness and substance abuse disorders. Those who experience this intersection of illness have higher risk of diabetes complications and are less likely to receive essential preventive care. But – Health New England is correcting this.

Health New England offers intensive, individualized care from a nurse with clinical experience treating people with diabetes, substance use disorder and mental illness. Receiving personalized care from a clinician who can address these compounding conditions helps members feel seen and heard, which builds trust and engagement.

The initiative identifies members with substance abuse challenges or mental illness as well as diabetes and engages with them multiple times via phone, mail and their primary care provider. Health New England educates members on their conditions, organizes transportation and enables communication between members’ care teams. Each of these elements help make care for diabetes less overwhelming and more accessible, giving patients the tools to manage their own health.

The program is not without challenges, as it can often take multiple attempts to engage a member in the program. However, Health New England has already seen how impactful it can be when they do reach members. In one instance, the personalized management plan helped a member with depression, ADHD and diabetes overcome hurdles to care by facilitating home delivery of diabetic supplies and connection with a therapist. A member engaged with this dedicated case management program credited involvement with “getting me back on track.”

Health New England’s personalized approach, tailored to individual preferences and medical priorities, helps break down care silos, fosters deeper member engagement and supports the journey toward wellness and recovery.