Overcoming Alcohol Dependence
A 60-year-old male, who lives with his spouse, has diabetes, cirrhosis, and hypertension. His prescription costs are high, and he is not in a protected plan. The member had an IP admission in 2016 for alcohol dependence and multiple gaps in care were noted.
Member Results
- Eventually opened up about prior alcohol abuse and also reported blood sugars in the 300s and prior A1c 13.9%
- Made great progress in lifestyle changes and diabetes management and is now fully engaged so PHN has more opportunity to impact member’s health needs, increase EBM adherence and coordinate with provider to assess additional needs
- Continues to be sober, and is walking 3.5 miles daily
How Conifer’s Personal Health Nurse (PHN) Helped
- Outreached member in June and member denied having any needs
- Educated member on DME benefit for diabetic supplies and then called again three months later
- Member again denied having any needs, but the PHN educated on gaps in care and encouraged member to discuss with his PCP and member agreed
- Called again in 3 months and member had closed those vaccine gaps as suggested by PHN and reported high blood sugars and needed education on diabetic diet but still did not fully consent to medical management
- Mailed diabetic education as requested and called to discuss with member
- When the member was hesitant to fully engage with PHN, she provided education and motivation in small increments and continued to follow up with member
- Over the period of a year PHN made consistent contact, provided requested education, coordinated IN DME for members diabetes supplies, monitored sobriety, and coordinated members insulin through ESI so he could afford his medications
Individualized Approach
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Help members navigate the care continuum to find the right care, in the right setting, at the right time —go beyond episodic case management or chronic disease management.
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