Aetna Member Story

Aetna’s Care Coordination Team Goes Above and Beyond for Member and Her Family

Sometimes, care coordination means thinking outside of the box when it comes to achieving the best health outcomes for members. Aetna Better Health knows this all too well. That’s why their care coordination team went beyond benefits and outside the typical network of care to provide the highest level of attention for the Henderson family and their newborn baby, Grace.

Grace was born on Feb 22, 2021, at 37 weeks and remained in the hospital for four days. After a subsequent hospital stay, she was diagnosed with crater willi syndrome at one month of age, which causes muscle weakness in all bodily systems, and in Grace’s case, obstructive sleep apnea. Grace was also initially fed through a tube in her stomach.

Grace and her family are from a small, rural town in Illinois, and they have to travel two hours to get to Grace’s specialty providers. This, of course, poses many challenges for Grace and her family.

Knowing this, Aetna’s care coordination team made sure to equip her family with all the tools, education, and resources they needed to help Grace thrive.

Aetna’s care coordination team facilitated:

• Connecting the family with specialty providers including a nutritionist, endocrinologist, pediatrician, pulmonary specialist, physical therapist, and occupational therapist.
• Ensured home health services were coordinated to help the family receive care closer to home.
• Made sure the family received ongoing education regarding Grace’s care, including CPR training.
• Connected the family with behavioral health providers and resources.
• Coordinated transportation services, going above and beyond the 90 miles stipulation to bring Grace home from the hospital.
• Provided safety planning and community resources for diapers and supplies to offset costs for the family.
• Ensured her necessary medical equipment was supplied through community partners.

Additionally, all first responders in the town, on their own time, traveled to the specialty hospital where Grace received care to get trained on what to do if the power were ever to go out and Grace needed to be transported to the hospital.

Since coming home from the hospital in March, Grace has not been readmitted. The family reports that she is currently swallowing, which was something she previously struggled with due to her condition. She’s also gotten stronger with physical therapy, was able to have her stomach tube removed, is now eating solid foods, and is starting to gain weight.

• Grace’s mother said thanks to Aetna Better Health, she feels more confident in being able to care for Grace’s special needs and the challenges they face as a family. Having a child with special needs can add stress to an already busy family. Having a care coordinator that was compassionate but was also able to relate, having toddler aged children herself, helped to put the family at ease.

“My goal is to continue to instill confidence in the parents and help them face any challenges they may have behaviorally, medically, socially and familiarly in the future, and decrease chances they may need to go back to the emergency room, which would put Grace at risk of infections,” said Cheryl Wyatt, Registered Nurse at Aetna Better Health.