When Nurse Support Makes All the Difference: One Family’s Story

nurse support

The Vincent White Family

Facing a Difficult Surgery

Vincent White tried everything to get rid of his back pain. Neck clamps. Surgery. Spinal decompression. This lab supervisor at Carolinas Healthcare had persistent pain from a narrowed bone channel housing the spinal cord and nerves.

The calcification worsened. Finally, doctors recommended another back surgery. “He was stumbling around the house,” said wife Lisa. “He could barely move.”

When Lisa walked into her husband’s hospital room after the operation, a doctor from the critical ICU team delivered bad news. Vincent was paralyzed.

“He was in ICU for 21 days,” said Lisa. “Doctors said he probably would not walk again.” Vincent had another surgery while in ICU to repair a spinal cord leak. After six weeks in rehab, he came home to his wife and 11-year-old daughter Olivia.

Experienced Nurse Support
Stepped In

Long before Vincent’s release, Lindsay Spainhour, RN, BSN, the Whites’ MedCost Case Manager*, was working with the medical providers, planners and discharge team. Lindsay followed his progress closely to ensure that he received all the care needed in this crucial time of their lives.

“Lindsay got to know me and took time to care about what my husband and I were going through,” Lisa said. “She got the special kind of air mattress we needed, and told us not to worry about authorization.” nurse supportLindsay called the supplier for Vincent’s wheelchair until it finally arrived. And when Vincent was diagnosed with a wound two weeks after arriving home, she provided education, supplies and questions for Lisa to ask medical staff when Vincent was readmitted to the hospital.

Vincent and Lisa continue to make lifestyle adjustments. He wears a catheter. He can’t take a normal vacation with his family. But Lisa says that their MedCost Case Manager made a big difference.

More Than Just a Job

“She did things she didn’t have to do, to make sure my husband’s needs were met over and beyond. I could tell in Lindsay’s voice that it was more than just a job.

“We sometimes complain about what we pay for premiums, but the benefits of having a case manager like Lindsay far outweighed the cost. Get a case worker. It can save you energy to focus on your family.MedCost


*The Whites gave MedCost permission to share their story to help others realize the benefits of the Complex Case Management program. MedCost Complex Case Management is a program where registered nurses who are also certified case managers work with individuals who have experienced a life-changing illness or injury. The goal of the program is to ensure the best use of available health plan resources while enhancing quality of life.

 

The Colonoscopy Screening That May Have Saved His Life

Sean Yacobi’s Story

colonoscopy screening

Sean Yacobi with his wife and children

Sean Yacobi had no symptoms when he decided to get his first colonoscopy. He made the decision after receiving a MedCost letter, urging him to get screened. What happened next was a total surprise.

I got a notification about getting a colonoscopy because I turned 50. I was a little anxious about my first colonoscopy to know that everything was alright. I felt fine, so I was taken aback when the doctors came in after the procedure that took longer than normal.

The doctor matter-of-factly said: “I found something. Nine times out of 10 it will be colorectal cancer.” The next few weeks were difficult because of the unknown. I got the good news that it had not spread and that they had caught it early, thanks to being screened.

I went that night, got blood work and set up with my oncologist. I felt like I needed an assistant to keep up with all the appointments.

With something like cancer, it’s typical to close up emotionally. When MedCost offered me participation in the Complex Case Management Program, I was a little skeptical. I’m a trial attorney. I wondered if MedCost was making sure I didn’t go past my benefit limits. But I found out that it’s been all about my care, and connecting the dots with all my different treatments.

I’ve had radiation therapy and inpatient surgery, followed by chemotherapy. It’s bewildering. There are difficulties beyond the illness. It’s just nice to know that above and beyond insurance coverage, MedCost’s Case Management gives you some peace of mind.

If you are dealing with medical insurance, you need support. Don’t be a lone ranger. Sometimes it’s humbling for men in general – I run my own business. It’s hard to realize I can’t solve everything on my own. If help is there, take advantage of it.

I’ve been willing to talk to MedCost people to tell them what’s going on. My Case Manager has a gentle manner that is very encouraging.

medicalYou have got to face things head on. When I talked to my gastroenterologist, he said: “It’s a good thing you came in.” I asked him what would have happened if I had waited five years for that screening. He said: “The news would not have been this good. It’s still early – you’re going to be okay.”

I’m going to focus on the finish line to get this behind me. This has made some positive changes in my life. After my surgery, when I was trying to get up and walk, I saw a lot of people who weren’t doing well. I heard people moaning in pain. Sometimes you need to see that to be thankful for what you’ve got.

I’ve got a lot to live for. God puts you with people that can help you. MedCost has been my sponsor. They got me to the screening and saved my life.MedCost

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If you are 50+ or have a family history or other risk factors for colorectal cancer, your health plan may provide a free colonoscopy. Check your health plan benefits for more details. Colorectal cancer can progress without any symptoms such as rectal bleeding or pain. Don’t wait to be screened.

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This testimony was published with permission from C. Sean Yacobi. To print, click on the title and scroll to “PRINT THIS PAGE” at the bottom.

 

 

 

Saving Health Costs: A Case Study

It is possible to save on health care costs. Here’s how.

savings hospital admissions health costs

Between 1999 and 2015, employer-sponsored health premiums rose 203%.i Deductibles for workers have mushroomed faster than both income and premiums. Businesses have struggled to find ways to contain these costs while providing for their employees.

This graph, “Health Plan Savings for One Employer,” is a real-life illustration of how wise management based on data analysis has saved millions of dollars for a MedCost client over the past five years.

When this client came to MedCost in 2010, hospital admissions were 87 per 1,000 covered lives. Without any changes in plan design or benefits, the MedCost clinical team ensured that patients received thorough follow-up care to avoid readmissions after joint replacements, cardiac and back surgeries and other procedures.

Skilled nurse managers helped schedule doctor visits and asked questions such as: “Are you taking all your meds? Is there anything you don’t understand about your care?”pregnancy, pregnancies, high risk pregnancy, health costs

Board-certified case managers and highly specialized obstetrical nurses focused on early identification of high-risk pregnancies, offering tips for prenatal care. Sometimes they interacted with doctors’ offices to help families get the answers they needed.

MedCost nurse health coaches worked with patients suffering chronic conditions such as high blood pressure, diabetes, migraines or congestive heart failure, helping them reduce symptoms, close gaps in care and comply with treatment plans.

The result? Better health for patients, and increasingly lower costs for employers. Since 2011, this employer has enjoyed five consecutive years under budget for health plan expenditures—as a result of data analysis and managing the right care at the right time through MedCost Care Management programs.

It is possible to save on health care expenses, using the right partner to manage employee health effectively. If you would like more information about this case study, please contact Jason Clarke at jclarke@medcost.com.

 

[1] “Recent Trends in Employer-Sponsored Health Insurance Premiums,” Kaiser Family Foundation, January 5, 2016, http://kff.org/infographic/visualizing-health-policy-recent-trends-in-employer-sponsored-health-insurance-premiums/ (accessed June 16, 2016).

 

To print this article, click on the title and scroll to “PRINT THIS PAGE” at the bottom.