Care Management Programs

For members with acute, chronic or complex health conditions, Fallon Health’s Clinical Integration Care Management programs can help you improve your quality of life and your health. These programs are free of charge, and you can choose to participate or not at any time―it will not affect your benefits.

Programs for members with acute short-term conditions

  • Case Management provided by our team of skilled Registered Nurse Case Managers helping to teach you about your conditions and communicate and collaborate with your medical providers
  • Care Coordination provided by our team of skilled Navigators working to educate you about your health plan benefits and providing you with community resources, such as transportation facilities, and other benefits available in your Plan
  • Special Deliveries, our Maternity Case Management Program provided by our team of skilled Registered Nurse Case Managers helping to coordinate care and services for you during your pregnancy and afterwards
  • Social Care Management provided by our team of skilled and experienced Social Care Managers helping to arrange community services, including benefits you may be eligible for based on your financial and other situations

Programs for members with chronic conditions

  • Chronic Disease Management Programs for those with asthma, cardiac conditions, congestive heart failure, COPD and diabetes
  • Our staff of health educators and nurses will work closely with you over the phone to help you live better with the challenges of your health condition. The health educators will provide support in the following ways:
    • Help you learn more about your condition
    • Give you information about online resources and local programs
    • Provide educational materials that focus on the latest information about living well with your condition
    • Arrange for equipment if you need it

Programs for members with complex conditions

  • Cancer support for members being treated with cancer
  • Case Management provided by our team of skilled Registered Nurse Case Managers who help teach you about your conditions. They communicate and collaborate with your medical providers to set personal health goals and develop and implement a plan to meet your goals.
  • Safe Transitions Program provided by our Fallon Health pharmacists who will work together with you and your providers to be sure the medications you’re taking are effective and up to date.

Learn more

To learn more about our programs and how you can participate, call us at: 1-508-799-2100, ext. 78002, Monday through Friday from 8:30 a.m. to 5:00 p.m.