December 30, 2014 Medical Conditions

Getting Help During a Health Crisis: CDPHP is Here for You

The CDPHP case management team helps members coping with complex medical situations such as aging, diabetes, cancer, HIV/AIDS, and high-risk pregnancy.

Facing a serious health setback? It is not easy to juggle everything that gets thrown at you following a new diagnosis, surgery, or injury. Members of CDPHP are fortunate to have access to a case management team who can help them get through it.

Whether you are coping with a life-threatening illness, high-risk pregnancy, or acute, short-term problem, our case managers are there to ease the pressure and confusion.

These caring professionals provide support, education, and helpful advice. They will work together to get you the help you need during a complex medical situation.

If you are a CDPHP member and facing issues related to aging, diabetes, cancer, HIV/AIDS, or any other serious health problem, consider using the CDPHP case management program. It is a covered benefit for all CDPHP members.

We can make regular check-in calls to discuss your condition and talk about ways to manage it. With support and education just a telephone call away through the CDPHP Single-source Referral Line, facing a frightening health crisis suddenly becomes a little less overwhelming.

A registered nurse can serve as a liaison between you and your medical team. The nurse can help you locate network providers, and answer questions about your medications, diet, or other needs.

A medical social worker can help you deal with other issues that arise—such as transportation needs and difficulties paying for prescribed drugs—and may recommend programs and services to make your life easier.

For individuals coping with mental health issues, a case manager from the CDPHP behavioral health department can join the team. The goal is to treat “the whole patient,” easing the transition from one health care setting to another. A behavioral health case manager can help you get mental health or chemical dependency care and advise you of help available through community resources.

We may even have an “embedded” case management nurse available at your doctor’s office. CDPHP has placed case management nurses in some of the area’s larger medical practices that participate in our Enhanced Primary Care (EPC) program. This gives our members the chance to meet face-to-face with a CDPHP nurse.

Making a Difference to Members

Sometimes a simple conversation and some caring encouragement can make a big difference for someone faced with a serious diagnosis. Here are just a few success stories from our case management department:

  • A CDPHP case manager helped a diabetic member struggling to lose weight. With guidance and support, the member lost more than 20 pounds and brought her hemoglobin A1C blood test to an acceptable level. “There’s a fine line between being pushy and sharing information that is helpful,” the member noted. “[The case manager] knew how to help me without being pushy. She could tell what I needed just from listening.”
  • A case manager’s advice meant the difference between life and death for one member. During a follow-up call after surgery, the member happened to mention a complication that the case manager recognized as a life-threatening event. She told the member to seek care right away, and met with the woman in the hospital. Understandably, this individual was extremely appreciative, saying, “She saved my life!”
  • A member diagnosed with cancer spoke frequently over the phone with a case manager to get emotional support and advice regarding the side effects of chemo. “This is such a hard time for me,” she commented. “It’s really a comfort to have someone to talk to and help me feel better.”
  • One of our nurse case managers built a rapport over the phone with a member suffering from lung disease. The member resisted using her oxygen because it embarrassed her. Over time, the nurse case manager convinced the woman to use the oxygen more regularly, and it helped her become more active and lose a little weight. The member was very grateful. “She’s a beautiful person and she helped me tremendously,” she remarked.

Going through some tough times? Reach out and a helping hand will be there to support you for what comes next. You, your practitioner, or a family member may inquire about case management by calling 1-888-94-CDPHP (942-3747).

Jane Wilson
About the Author

Jane joined CDPHP in 2007 and has held several positions of increasing responsibility with the Medical Affairs division. She currently serves as the Manager of the Care Management Department. In this role she oversees a team of Registered Nurses and Social Workers who are charged with helping CDPHP members understand their medical treatment plans, improving coordination of service across the continuum of care and addressing the health needs of “the whole person.” Jane is a NYS Registered Nurse. She received her M.B.A. in Health Systems Administration from Union Graduate College and her Bachelor’s degree in Nursing from SUNY Institute of Technology. She also holds an Advanced Certificate in Project Management from Stanford University.

Comments are closed.

Get our favorite local activities, health tips
and more, each month.