Member Success Stories: Care Coordination for a Complex Member

Posted February 11th, 2009 by magnolia health plan & filed under Member News, Newsroom.

“Mike,” an 18 year old member, was involved in an accident resulting in severe brain injury and coma. He spent 36 days in the Intensive Care Unit and required artificial ventilation. Mike had multiple needs, including nutritional challenges, sedation requirements and was in need of neurological rehabilitation services that were not available in his Service Area.

A case manager was assigned to meet Mike’s immediate needs and ensure continuity of care after facility discharge. The case manager educated Mike’s caregiver about what to expect during and after hospitalization and linked her to community resources and support groups. She arranged for Mike to receive specialized treatment and therapy from a non-network inpatient rehabilitation facility, and prior to discharge, the case manager arranged for durable medical equipment (including a specialized wheel chair and feeding tube supplies), home health services and outpatient therapies. Following discharge, the case manager continued coordination with community services, including a daycare program and other special programs in
the member’s area.

Today, Mike continues in the daycare and his family has the necessary skills, knowledge and services to incorporate his needs into their daily routine.