Our Disease Management Programs

Neighborhood Health Plan of Rhode Island (Neighborhood) has disease management programs for your patients with asthma, chronic obstructive pulmonary disease (COPD), diabetes and heart failure.

The goal of the disease management programs is to enable and empower members to live normal, healthy lives, and be confident in their abilities to manage their chronic condition. Built on evidence-based clinical practice guidelines, these programs are designed to reinforce the practitioner’s care and treatment plan through member outreach, education, monitoring and self-management.

  • Breathe Easy is our asthma program. Members 2 years old or older are automatically enrolled in this program when identified through claims data as having persistent asthma.
  • Take a Breath is our COPD program. Members 40 years old or older are automatically enrolled in this program when identified through claims data as having COPD.
  • Healthy Heart is our heart failure program. Members 21 years old or older are automatically enrolled in this program when identified through claims data as having heart failure.
  • Control for Life is our diabetes program. Members 18 years old or older are automatically enrolled in this program when identified through claims data as having diabetes.

All members enrolled in our disease management programs receive:

  • Newsletters with tips and information about how to manage their chronic conditions.
  • Access to a nurse who will provide health coaching. While health coaching is primarily telephonic, meeting with members in the community can be arranged.

If your patient receives Neighborhood’s health coaching, our goal is to reinforce your treatment plan so they can understand how to manage their condition. Our nurses will notify you of your patient’s engagement in the program, any issues identified during the assessments and planned interventions.

If you would like to refer your Neighborhood patients who have one of these conditions to receive educational mailings or to work with a nurse health coach, please call us at 1-800-459-6019 (TTY 711). These programs are voluntary. If at any time your patient wishes to stop participating in one of disease management programs, they can call us and request to be removed.

In addition to our disease management programs, Neighborhood also offers a tobacco cessation program for members called Quit for Life.