When our members need extra help, Highmark care management teams are there.
Lamar* was skipping his doctor's appointments. And no one knew why.
Then he told his story to a Highmark case manager. Lamar's chronic lung disease and his bulky oxygen tank made it a real struggle to get to the doctor's office. The care management team arranged for a smaller, more portable oxygen tank so he could move around more freely. Now, Lamar makes his doctor's visits, plays with his dog and works in his garden.
Lamar is living proof that talking to a case manager who listens and takes action can enable better health and quality of life.
At-risk members work with Highmark's care management teams, which can include:
They work together to find solutions specifically tailored to a member as a whole person, considering his or her emotional, mental and physical needs to achieve the best possible overall health. They can even help overcome financial or physical barriers to getting care.
Roberta* was a longtime smoker with breathing problems, infections, chronic arthritis and depression, and she needed help.
She wasn't taking her medicine. And her health was in decline.
Her Highmark care management team took quick action. They discovered Roberta didn't know how to use her inhaler and couldn't afford her medicines. They found government help and community services to help pay for them and they helped her use her health plan more effectively. And Roberta learned how to make some needed changes.
She began using her inhaler and taking her medicines regularly. She quit smoking, with help from a health coach, and became more physically active. And as she saw a healthier future, she opened up to the idea of seeing a behavioral therapist and reduced her stress and depression.
For someone who is elderly, sick or alone, care management team members can provide a human connection and bring hope where there was none. They can even help overcome financial or physical barriers to getting care.
Jeanette* needed help dealing with her terminal cancer, almost as much as she needed someone to talk to. With help from the case manager and social worker on the team, Jeanette was able to write her living will and arrange for home care nurses for her sick husband. The team coordinated services to obtain essential items to restore Jeanette's independence and confidence, including:
These changes enhanced Jeanette's daily life, but the ultimate accomplishment was to deliver oxygen and the other health care services she and her family needed during one last vacation trip. "I wanted her to know she was not alone," said the care manager.
Jeanette's independence is living proof that considering the whole person is the key to better health, at any stage of life.
*Lamar, Jeanette and Roberta are real people. Their names have been changed to protect their privacy.