HAP’s care management programs support members with serious conditions, and eligibility differs by program.
HAP lists several clinical programs for members with chronic or complex conditions. Each has its own eligibility rule, and some apply only to certain plan types.
What the program is and what members do.
Care management and transitions
HAP says its Care Management Program helps members with chronic or complex conditions understand their condition, stay connected to the care team and manage their health. After a hospital stay, HAP says a case manager calls to coordinate care and follow-up visits, and HAP works with network hospitals on discharge planning.
Digital back and joint pain
HAP lists a digital musculoskeletal program through Protera Health, offering telehealth medical consultations, physical therapy, nutrition counseling and pain management education through an online portal. Members register, complete a health assessment and wait for Protera to schedule a first virtual visit. Patient-reported outcome measures guide the recommendations.
Hospital at Home, palliative and medication support
HAP says Hospital at Home gives eligible members an alternative to a hospital or skilled nursing stay, with a care team treating them at home. HAP also lists home-based palliative care and a behavioral antidepressant medication management program, which provides written outreach, support and education to members taking antidepressants.
Eligibility, funding and plan design.
Who can use it
HAP labels each program separately. Care management and transitional care are open to all members. The Protera program lists Medicare Advantage, commercial and all ASO group members. Hospital at Home lists ASO HFH, fully insured commercial and Medicare Advantage members. The antidepressant program lists employer group and Medicare members.
How it is funded or sold
HAP presents these as plan programs and does not publish prices. Because they run through the plan, costs sit in premium or self-funded claims and administration. Ask HAP whether any program carries an administrative fee for self-funded groups and whether the employer must opt in.
Where it fits in a plan design
These programs target high-cost or high-risk members rather than the whole population. Protera is an alternative route to musculoskeletal care, and Hospital at Home affects inpatient claims. They matter most to self-funded employers and stop-loss reviews, and less to groups looking for an engagement tool.
What to settle before relying on it.
Which of these apply to our funding type?
The eligibility lists differ by program, and HAP uses the labels commercial, ASO and ASO HFH. Ask HAP to map each program to your plan and funding arrangement in writing, so employees are not promised something their plan does not include.
What is the Henry Ford network connection?
Hospital at Home is tied to Henry Ford Health members in HAP’s listing. Check whether employees live and receive care in the area where it operates. A program that few employees can reach should not weigh heavily in a plan comparison.
What outcomes does HAP report?
HAP describes goals rather than publishing results for the Protera program or care management. Ask for utilization and outcome data at group level, and for how Protera is paid. A musculoskeletal program should be judged by whether it reduces unnecessary imaging and surgery, not by enrollment alone.
Common questions about this program.
Is HAP’s care management open to everyone?
HAP lists its Care Management Program and transitional care management as open to all members. Other programs on the same page have narrower eligibility.
Who can use the Protera back and joint program?
HAP lists Medicare Advantage, commercial and all ASO group members. Employers should confirm that their plan type is included.
What does Hospital at Home involve?
HAP says eligible members can receive care at home from a team that can include physicians, nurses and social workers, instead of a hospital or skilled nursing stay. It is limited to the member types HAP lists.
Programs and vendors named on this page
Official pages for the services mentioned above. Availability, cost and eligibility vary by plan and employer group, so confirm what applies to your group with the carrier.
Where these details come from.
This page summarizes what Health Alliance Plan publishes. Programs change, so confirm current details with the carrier before relying on them.
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