Success Stories from VNSNY’s New CMO: A Broken Hip Gets Treated and an Anxious Patient is Reassured

Since the launch of VNSNY’s Care Management Organization (CMO) in early May, the new business unit has already had a significant impact. Here are two recent examples of how our CMO team has helped support the health of vulnerable CHOICE members:

A Worrisome Call Leads to Diagnosis of a Hidden Hip Fracture

A CMO Care Manager got a worrisome call from a Partners in Care nurse who had just visited a CHOICE member enrolled in the CMO. The member’s home health aide had told the nurse that the member suffered a fall—but the member denied that any such fall had happened. The Care Manager promptly sent Geralda Pellisier, a nurse practitioner with VNSNY’s Population Health team, to the member’s home to perform an assessment and determine next steps.

Once Geralda arrived, the member was still reluctant to admit that anything was wrong, but she did acknowledge that her right leg was in pain. After noting that the member’s right hip was deformed and that she couldn’t bear weight on the leg, Geralda and the Care Manager conferred and arranged for an immediate home visit from the member’s primary care doctor. Concerned about the possibility of a dangerous blood clot, Geralda stayed with the member until the doctor arrived. When the doctor got to the member’s home, he confirmed that she’d fractured her hip and had her transferred by ambulance to the hospital.

The Takeaway: Our CMO prevented the development of potentially serious complications that could well have occurred if there had been further delay in diagnosing and treating this CHOICE member’s broken hip.

 

Responding to a CHOICE Member’s “Trembling Voice” by Tracking Down a Vital Medical Equipment Delivery

When CMO Care Manager Jeff Halusic made phone contact with another CHOICE member to enroll her in VNSNY’s new Care Management Organization, he was struck by her anxious tone and trembling voice. When Jeff asked what was wrong, the member told him her oxygen compressor delivery was late and she was worried that the company had forgotten about her. She added that she had called the oxygen company several times, but was unable to reach a company representative.

After hearing the member’s concerns and explaining that he understood her anxiety and frustration, Jeff reassured her that she had not been forgotten and that he was there to help. The member then gave him permission to contact the equipment vendor directly. Jeff called the company and determined that the oxygen compressor would arrive at the member’s home by 6 p.m. that same day. He passed this information on the relieved member, then followed up with a call to her that evening to confirm that the equipment had been delivered. The member thanked Jeff for relieving her anxiety and “for listening.”

The Takeaway: VNSNY’s enhanced care management was able to relieve what had become an acutely anxious situation for the CHOICE plan member and ensure that she had the vital equipment needed to keep her safe and healthy at home. At the same time, Jeff’s proactive assistance reinforced to the member the fact that she could rely on VNSNY’s watchful support.