Nancy*, a Priority Health Medicaid member, has seen her share of health challenges and struggles. Suffering from chronic migraines, persistent asthma and chronic obstructive pulmonary disease (COPD), Nancy knew she needed help to get and stay healthy.
In 2015, Nancy moved to northern Michigan from another state and struggled to find a primary care provider in her new city. All the doctors in her area were full and no longer accepting new patients. As a result, she found it difficult to get prescriptions and would stretch her supply of medications to make them last longer. This caused her conditions to worsen, leading to trips to the emergency room to get refills on her inhalers and receive the care that most people would get from their primary care doctor.
Today, Nancy’s health is vastly improved. Her new doctor makes sure she has the correct amounts of her prescriptions and that they are being filled on time.
Within the last year, Nancy was connected with a Priority Health case manager. During their first conversation, Nancy mentioned that she was nearly out of her medications again. She also told her case manager that her birthday wish was to find a doctor that was willing to take her on as a patient. Nancy’s case manager called the doctors in the surrounding area and found that none were accepting new patients – some had waiting lists and others had such a large backlog that they didn’t even have a waiting list.
After further research, the case manager found two physician’s assistants at Spectrum Health Gerber Memorial accepting new patients. When Nancy’s case manager confirmed her appointment, she was overjoyed to finally get the help she needed. As luck would have it, Nancy’s doctor appointment was two days before her birthday – just in time to make her birthday wish come true.
Her new doctor was able to fill the gaps in care. She received immunizations, lab work, a mammogram and a colonoscopy. Nancy was also referred to the pulmonology department to address her asthma and COPD.
Just like Nancy’s care manager, Priority Health’s team of care managers help coordinate health care for members by:
- Identifying patients for providers that require clinical support
- Providing tools and resources about specific conditions
- Communicating with members on the care and education offered to the patient
- Notifying members of any needed tests, abnormal lab values or significant changes
- Working directly with members to maintain a high quality of care
Today, Nancy’s health is vastly improved. Her new doctor makes sure she has the correct amounts of her prescriptions and that they are being filled on time. Now, she is also getting the proper preventative care, like regular mammograms and other procedures, to make sure that she’s staying in good health.
Nancy is very thankful for the help from her Priority Health care manager and everyone involved. She said that getting her health taken care of was the “best birthday present ever.”
*The member’s name has been changed to respect their privacy.
