WellCare of New York Expands Field-Based Care Management Program to Deliver Personalized Care for High-Risk Members

News provided by

Oct 19, 2016, 08:30 ET

NEW YORK and TAMPA, Fla., Oct. 19, 2016 /PRNewswire/ -- WellCare of New York, a subsidiary of WellCare Health Plans, Inc. (NYSE: WCG) dedicated to serving Medicaid, Medicare and Long Term Care members in New York, expanded its field-based care management program this year to better serve high-risk members. The program was implemented last year to serve Medicaid members, and expanded this year to also include Medicare members.

WellCare of New York nurse and care manager Trisha Simon visits Maria Marte in her home in the Bronx as part of the company's newly expanded field-based care management program. Through home visits, care managers are able to assess and address any gaps in members' care; provide assistance in navigating the health care system; develop collaborative care plans with physicians to manage members' chronic conditions; and help members access the appropriate level of care in the most appropriate setting.

Maria Marte, pictured in the wheelchair above, is surrounded by her family and WellCare of New York President John J. Burke (far left) and WellCare of New York care manager Trisha Simon (far right). Mrs. Marte is a WellCare of New York member who was assisted by the company's field-based care management program, which is designed to provide personalized care to high-risk members to help them improve and maintain their health.

Face-to-face engagement with members enables WellCare care managers to assess and address any gaps in their care. Care managers provide assistance in navigating the health care system, develop collaborative care plans with physicians to manage members' chronic conditions, and help members access the appropriate level of care in the most appropriate setting. In addition, care managers connect members to community-based organizations to address social service needs, such as housing and transportation. These unmet needs can make it difficult for members to prioritize their health.

"As a result of this year's expansion to serve Medicare members, we expect to assist approximately 2,000 members through our field-based care management program," said Dr. Jerry Frank, WellCare of New York's medical director. "Our care managers visit members in their homes to assess their needs and develop customized care plans. These personalized health interventions are designed to help members get on a path to better health by providing services and support they may not have been aware of or even realized they needed."

Maria Marte, 69, is one of those members.

Marte is diabetic, suffers from heart disease and her kidneys were failing. She was struggling with the decision about whether to get dialysis. After a long hospitalization, her medical team convinced her she would not get better unless she sought the life-saving treatment. However, orchestrating the care proved an even bigger challenge.

Trisha Simon, a registered nurse and field care manager for WellCare, stepped in to provide the support and medical equipment and supplies the family needed to help Marte transition home and begin the thrice-weekly trips to the dialysis center. Simon arranged for an ambulance service to take Marte to every visit. The family lives in a three-story walkup in the Bronx, and an ambulance crew picks her up at her door and takes her down three flights of stairs on a stretcher, along with her portable oxygen.

"Without Trisha's help I would have been like a fish out of water," her daughter, Evelyn Marte said. "She couldn't go down the stairs so we had to think about transportation, oxygen, a stretcher, an ambulance. It was a life change and Trisha totally helped us get the supplies my mom needed."

"The Martes reminded me of my family," said Simon, who has been a nurse for four years. "She has such a large, supportive family and everyone was rallying around her to help her get better. At WellCare, we wanted to do everything we could to support them and help Mrs. Marte enjoy a long and happy life with her family."

To learn more about how WellCare cares for its members, watch Marte's story at https://www.youtube.com/user/WellCareHealthPlan.

As of June 30, 2016, WellCare serves approximately 122,000 Medicaid members, 42,000 Medicare Advantage members, 55,000 Medicare Prescription Drug Plan members and 7,000 Managed Long Term Care members in New York.

About WellCare Health Plans, Inc.
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services, primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, to families, children, seniors and individuals with complex medical needs. WellCare serves approximately 3.8 million members nationwide as of June 30, 2016. For more information about WellCare, please visit the company's website at www.wellcare.com or view the company's videos at https://www.youtube.com/user/WellCareHealthPlan.

Photo - http://photos.prnewswire.com/prnh/20161018/430084

Photo - http://photos.prnewswire.com/prnh/20161018/430083

Logo - http://photos.prnewswire.com/prnh/20150701/227667LOGO

SOURCE WellCare Health Plans, Inc.