PUTTING MORE CARE INTO CARE MANAGEMENT PROGRAMS

At Blue KC, we realize each member’s health journey is unique. That’s why we developed BluePath, our personalized care management program. BluePath is based on years of member experiences and the experiences of our own clinical staff. With strong ties to the community and the region’s health systems, we can meet members wherever they are in their personal health journeys.

We provide critical one-on-one support for our members from our in-house medical directors and compassionate nursing staff with a range of specialized backgrounds. And because no two members are alike, we take a personalized approach to care management based on each individual’s unique health status.

With BluePath, we can help members navigate a complex health system, improve outcomes and deliver an optimized care experience.

When expertise and personalization cross paths good things happen

BluePath pinpoints members with health issues early in their diagnoses like diabetes, hypertension and heart failure. By acting quickly, we can slow the progression of a condition and improve a member’s health. We match members with the resources and tools to guide the best possible journey for their health status.

For example, members who are at risk for developing Type 2 diabetes have access to a free Diabetes Prevention Program to help them adopt healthy lifestyle habits and reduce the risk. For members with a diabetes diagnosis, our Livongo for Diabetes self-management program empowers them to personally keep track of their glucose measurements by providing glucose monitors, unlimited health strips and personalized health coaching.

“I joined Livongo as soon as it was offered by my employer. I am single and live alone. I love that I can set a threshold for my daily readings, and when they fall above or below threshold, a Livongo team member reaches out to me via text or phone call. Lows can be very scary, you break out in a cold sweat, you get shaky, sometimes disoriented. It’s reassuring that they will call and check on me.”
-Scott Bundi, Administrative Coordinator, Water District No. 1 of Johnson County

Compassionate and well-educated case managers are the guiding force of BluePath. “Our case managers work directly with the members to maximize their benefits and help them navigate their unique health journey,” explained Julie Ham, Director, Care Management.

Sometimes, the job of a case manager calls for asking difficult questions and being creative. Sometimes, it calls for handholding, but it always calls for high-touch care.

Initially, many members are hesitant to open up. “Our nurses do a fantastic job of breaking down barriers to learn what’s really going on with individuals and uncover how they can help,” Ham shared.

Care management expansion

To better serve the needs of our members, several new programs were developed under BluePath in 2019 – including Rare Autoimmune Disease Management, Oncology and Traumatic Brain Injury. Moreover, additional case managers joined new and existing programs.

Part of Care Management’s expansion included building in some specialty areas and assigning a nurse with expertise specific to that area.

The High-Risk Maternity program added a Neonatal Intensive Care Unit nurse and an experienced pediatric nurse to work with disabled children. The Oncology program gained two seasoned oncology nurses from a local health system and is led by a practicing oncologist, Dr. Tracy Miles. And the Traumatic Brain Injury program is now led by a rehabilitation specialist, Dr. Raelene Knolla and supported by nurse practitioners with traumatic brain injury and rehab experience.

What’s so unique about Blue KC care management?

All payors have care management programs, but only Blue KC has built specialty areas led by experienced care managers.

“Our Blue KC team is a phenomenal asset to our employees. Recently we had an employee that was prescribed an expensive drug for a chronic medical condition.  The prescription was for a high-cost medication, and the BluePath team was able to find an alternative drug solution at a much lower cost.  Their support had a significant impact on our plan cost as well as the employee needing the medication. The cost savings alone was a win for everyone!”
-Joy Cofield, Director of Human Resources Administration, Fellowship of Christian Athletes

“What sets us apart? We’re able to effectively engage and help provide members with a high-touch, empathetic approach to care,” said Ham.

A care management success story named Grace

Grace is a three-year-old with Down syndrome. She attends a therapeutic preschool at Ability KC. “Grace gets therapy right in the classroom, alongside her peers, which is great. But there are some limitations on her speech, physical and occupational therapy throughout the year,” explained Meredith Atherton, Grace’s mom.

“One year she won a scholarship to pay for additional visits. But she needed more therapy,” Atherton shared.

Atherton found a passionate advocate in Jennifer Palmer, Clinical Nurse, Case and Disease Management at Blue KC. Palmer also has a child with Down syndrome, so she has a personal understanding of Grace’s health needs.

Palmer spoke to the challenges of caring for a child with a disability and a chronic condition. “Our medical system is super fragmented. Imagine being a parent dealing with a medically fragile child on top of that. Working parents are spread so thin. I’m here to help,” she said.

Advocacy and healthcare navigation account for 75 percent of the case manager’s time.

“I advocate for every patient, so they have the best possible outcome,” shared Palmer. “I’m always asking, how can we set up kids to thrive as they grow older?”

Palmer is an invaluable resource – and an outspoken voice – for patients. When Grace needed more speech therapy, Palmer found a solution. Atherton shared, “Grace is now getting speech therapy twice a week, and we saw immediate results. She’s even able to tell her brother NO.”

And yes, Palmer did more than get Grace extra speech therapy. She’s also helping the family navigate everything from Grace’s Individualized Education Program issues to helping Grace qualify for lifelong disability support.

As Grace finds her voice, it’s music to her mom’s–and her case manager’s–ears. “Grace sang 'Country Roads, Take Me Home’ the other day,” said Atherton. That’s how care management has put one toddler on the right path.