Molina Member Story

Jacob is a 52-year-old man from DuPage County who has a history of high emergency department utilization and frequent inpatient visits. Jacob has several medical diagnoses including heart failure, anemia, diabetes, hypertension, coronary artery disease, high cholesterol, and history of strokes. Jacob also has some behavioral health issues that led to him not engaging with his providers or taking his medications properly.

Getting Help

Jacob was referred to the Molina case management program. Jacob and his case manager met to talk through his history and challenges. Jacob stated that his primary care physician was not helpful and did not listen to him. Jacob’s case manager helped him find a new PCP and made sure the doctor had his medical history. Jacob’s case manager attended his appointments via teleconference and helped him express his healthcare needs. The PCP developed a treatment plan to address all his health needs. Jacob and his case manager continued to meet and talked about the importance of taking his medications and discussing treatment with his providers. Jacob did lab work and was linked with specialty providers for podiatry, ophthalmology, endocrinology, and cardiology, and received CT scans. Jacob’s case manager continued to help him set up transportation for his appointments and made reminder calls. His case manager helped manage his progress and provided ongoing support.

Now

Jacob no longer utilizes the emergency room as his primary source of healthcare. He continues to attend all of his appointments and has positive relationships with his care teams. Jacob states that his new PCP has been quick to address his concerns and prescribe medication refills. Jacob continues to take all his medications and stays engaged. Jacob reports better numbers for his diabetes based on his treatment plan. Jacob has incorporated a healthier diet with suggestions from his medical team. Jacob continues to work with his case manager to navigate his health. He stated that he trusts his case manager.