Our Members' Stories

Teresa, a CareFirst employee and member, first began working with her care coordinator, Felicia, after several urgent care and ER visits. Lab work had indicated her hypertension and Type 2 diabetes were accelerating, so Teresa’s primary care provider (PCP) who participates in CareFirst’s Patient-Centered Medical Home (PCMH) program agreed she would be a good candidate for chronic care coordination.

Instead of adding more medications and specialists visits,Teresa wanted to figure out how to improve her condition and take an active role in her health. She was open to the help after previously working with a disease management coach. She states, “I was assigned a coach who was very engaged in my chronic condition. She would call me monthly and we had good discussions about weight, medications,etc. I switched over to a PCMH nurse and I am pleased that we can chat weekly about any medical concerns I am having. She is available via text, email or phone. I feel very comfortable sharing any health concern with her, and that she will contact my doctor on my behalf as well.”

Teresa

"Having the coach keeps me accountable. I don’t want to let her down or not do something I said I was going to do. Her support has pushed me to keep things up and to live a better life overall!"

Through their weekly care coordination calls, Teresa and her nurse work through health concerns, medication questions, and review glucose readings. They have extensive conversations as Teresa is actively managing a complex condition she was diagnosed with more than ten years ago. “Some weeks everything is going great, other times we have a longer conversation and lots to go over,” Teresa states. Adding, “Having another person to advocate for me is beneficial. My nurse is able to get answers to my questions and concerns.”

One goal was to lower Teresa’s A1C – an important measure for diabetics. Felicia helped Teresa enroll in a local diabetes education program and encouraged her to remain physically active, even recommending a few exercises to avoid based on her specific situation. Additionally,one medication Teresa was prescribed was causing some uncomfortable side effects. Felicia worked with her to help prevent the reoccurring infections, teaching techniques to prevent them or to treat them early on with over-the-counter remedies. The nurse, along with Teresa’s dedicated customer service representative, also helps with benefit questions and clarifications to ensure she has no unexpected costs.

A registered nurse for more than 30 years, Felicia believes strongly in the value of care coordination for patients like Teresa. “Aligning ourselves with the patient and helping them along until they’re self-managing their care is so important. A nurse reviewing member records is able to identify patients who are unstable, maybe at home without the proper services, who don’t know the next step to take. I love working with these patients to help them achieve goals and empowering them to know they have choices, and that it’s okay to ask their PCP for help. PCPs are very busy and I am able to invest the time needed to run interference and get questions answered, helping these patients come to the attention of their PCPs.”

Through the support of care coordination, Teresa’s health has stabilized. She is self-motivated and has been very compliant with the goals her nurse care coordinator and PCP have set with her. Describing her experience, Teresa shared, “It doesn’t take a lot of your time and can be very beneficial. The more help you can get when you have a chronic condition, the better off you are. You take more of an active role when you have a team of people behind you and you feel accountable.”

It doesn’t take a lot of your time and can be very beneficial. The more help you can get when you have a chronic condition, the better off you are. You take more of an active role when you have a team of people behind you and you feel accountable."

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