When a woman broke her femur in a fall, she was admitted to a rural Maine hospital where doctors discovered she had a pulmonary embolism that may have contributed to the weakness that triggered her collapse. That made the situation much more complicated.
Once alerted to the case, a Community Health Options Care Management team member called the hospital, made some simple introductions and offered to assist. But while the hospital’s care manager appreciated the call, she wasn’t sure how an insurer could help—what they really needed was someone who could find a rehabilitation facility.
But finding a rehab facility is exactly how the Care Management team can help Health Options’ Members. Our team quickly found an in-network rehabilitation facility and helped obtain the durable medical equipment the woman needed to start walking again. Then, once the woman was at the rehab facility, the care manager scheduled weekly updates with the rehab’s social worker to ensure a smooth transition and help coordinate care.
Even amid a setback—the woman wound up back at the hospital with sepsis—Care Management continued to ensure continuity of care and helped get the patient back to the rehabilitation center. By coordinating this kind of collaboration between providers and facilities, Health Options looks to create better health outcomes for Members, often while keeping costs down.
Health Options’ Maine-based Care Management team helps patients work through life’s toughest challenges, even helping to find meal services to remove such barriers to health as food insecurity or finding transportation to ensure Members can get to important appointments. The team also shows Members how to save on long-term prescriptions by using mail order and patient assistance programs or taking advantage of retailer discounts and coupons.
One Member recently said, “My care manager, without hesitation, has provided resources that I needed and some that I didn’t even know I needed! I know how busy we all are, and my care manager has always made me feel like a priority.”
Health Options Members can get help managing chronic conditions, ensuring smooth transitions from the hospital to home, finding behavioral health resources and managing maternity and post-partum care. Additionally, Heath Options’ Medical Management team offers complex care management for Members experiencing diagnoses such as metastatic cancer, organ failure or pediatric trauma.
There’s more information on medical management and care management on Health Options website. To access these services, call our Maine-based Member Services team at (855) 624-6463, available from 8 a.m. to 6 p.m., Monday through Friday.
You are cordially invited to join Health Options' 2021 Annual Member Meeting on Thursday, November 18, from 4:30 – 6:00 p.m. via Zoom's online meeting platform.
Use this Health Options' 2021 Annual Member Meeting link to register and get the login details at Eventbrite.
Our 2021 meeting will cover Health Options' year in review, including fiscal updates, grant activity, improvements to plans and procedures, and the 2022 Board of Directors’ election results. We will be joined by two speakers: Tym Rourke, senior director at Third Horizon Strategies and former director at the New Hampshire Charitable Foundation, and Leslie Clark, executive director of Portland Recovery Community Center (PRCC).
Tym and Leslie will discuss “The Other Epidemic: Escalating Substance Use Disorders in Maine and Beyond.” As the pandemic continues, it’s more important than ever to devote state, federal, and community-based resources to removing barriers to care and improving substance use treatment. Tym and Leslie will discuss their experiences working to provide greater access to prevention, treatment, and recovery services.
For questions about the meeting, contact Health Options Member Services, Monday through Friday, 8:00 a.m. – 6:00 p.m., at (855) 624-6463.
And remember to let your voice be heard! All Health Options Members 18 years and older are eligible to vote in our board of directors’ election. Candidate biographies and voting instructions have already reached you by email or traditional mail. Voting ends November 5, 2021.
