At WellCare, our goal every day is to get our members the care they need. This can be much harder than it sounds.
Take, for example, a member who was recently hospitalized for a serious bout of pneumonia. This was not her first encounter with a breathing problem; she had suffered from severe asthma since childhood. Our goal was to provide her with a personalized, field-based care manager who could help her get and stay healthy.
But there was just one problem: we couldn’t reach her. The member had moved and had not shared her new contact information. When faced with challenges like these, we often work with partners like Integra ServiceConnect®, a community-based health care support company that assisted WellCare of New York in locating more than 300 members with complex physical and/or behavioral health needs last year.
Integra’s community health workers use several community-based resources to find our members when the contact information on file is out of date. They assist us in locating the member and connecting the member to needed care. They use well-known programs, such as Google and Lexis Nexis, and visit last-known addresses and social service agencies—similar to a good television detective. This feet-on-the-ground work helps us find members who may need our help to get the care they need, including medication and follow-up care to better manage chronic conditions, and in some cases to avoid more hospitalization.
Integra is just one way WellCare partners with community-based organizations to help our members get high-quality, affordable care.
Our relationship with Healthplex Dental Services is another example of how we serve our members in New York.
Through HealthPlex we provide our members with a comprehensive dental network that allows access to primary preventive dental services and encourages our members to establish a “Dental Home,” or a dental provider a member visits regularly. Programs also encourage parents to take their young children to the dentist in order to start healthy habits early in life and get regular, annual check-ups and fluoride treatments to help prevent cavities.
Because WellCare believes in assisting members in maintaining their total health, we recently started working with Cobalt Therapeutics to provide our members with a unique online program that helps them to address their mental health. These programs are designed to address problems members may be experiencing with insomnia, depression, anxiety and substance disorder. While these are not substitutes for professional help, these self-help modules can provide important insights into very common conditions.
At WellCare, we understand that our members can face barriers that prevent them from obtaining the health care they need. To help, we’ve embedded ourselves into the communities where our members live and formed partnerships with local, community-based organizations to help us better serve them. Our mission is to help our members lives better, healthier lives; and our partnerships help make this possible.
Dr. Jerry Frank is medical director for WellCare of New York.