Hally® Healthcast is the monthly wellness podcast from Hally health.
This month we’re talking about care coordination – the fancy term for the personalized help and support some health insurance plans offer their members. We want to spread the word about this helpful service, since many people aren’t aware it exists and others don’t know if they qualify for it. By the end of today’s episode, you’ll not only learn if care coordination is right for you, but you’ll also hear exactly how it can help you live your healthiest life. And, of course, we’ll let you know how to sign up.
Here with us today are three special guests – all work for Health Alliance, based in Champaign, Illinois, bringing care coordination services to members. Karen Noffke and Melissa Cecil are both care coordinators, Brian Plotner is a health coach, and all three are experts in the services they provide.
Listen here, or read a quick summary in the article below.
Caitlin Whyte (Host): Welcome to Hally Healthcast, the monthly wellness podcast from Hally® health – your partner in helping you live your healthiest life.
Every month on our podcast, we address a new topic important to your health, bringing in expert doctors, nurses, therapists and specialists who offer advice and answer your most pressing questions.
This month we’re talking about care coordination – the fancy term for the personalized help and support some health insurance plans offer their members. We want to spread the word about this helpful service, since many people aren’t aware it exists and others don’t know if they qualify for it. By the end of today’s episode, you’ll not only learn if care coordination is right for you, but you’ll also hear exactly how it can help you live your healthiest life. And, of course, we’ll let you know how to sign up.
Here with us today are three special guests – all who work for Health Alliance, based in Champaign, Illinois, bringing care coordination services to members. Karen Noffke and Melissa Cecil are both care coordinators, Brian Plotner is a health coach, and all three are experts in the services they provide.
Welcome to you all, and thank you so much for being here.
Before we begin, an important note. Care coordination and health coaching are not a replacement for the care you get from your doctors, nurses and other healthcare professionals. They are added support that helps you reach health goals, stay on top of your well-being and navigate the complicated world of healthcare. Think of coordinators and coaches as partners and allies at your side, helping you live your healthiest life.
So, let’s just jump into it. First of all, before we get into any specifics, can you tell us broadly what care coordination is? How would you describe it in just a sentence or two? Ms. Noffke, we’ll start with you.
Karen Noffke, RN-BC, MSN (Guest): Okay, care coordination is intended to maximize the value of the care being delivered and ensure that our members’ needs and preferences are known and addressed. And the goal is to provide safer and more effective care by sharing that pertinent information among all the providers involved with that member.
Host: Well, thank you for that. And anything you’d like to add Miss Cecil?
Melissa Cecil, BA, CCM (Guest): Yes, I would. Thank you. So, we also have a care transition intervention as a part of the care coordination program, which helps with transitional needs. And we also have a behavioral health component as well.
Host: Wonderful. And Mr. Plotner, can you tell us a little bit about health coaching? Is it the same as care coordination or different? How would we describe it to our listeners?
Brian Plotner, MPH (Guest): Yeah, health coaching. It’s a little different, right? So, with health coaching, it’s really about meeting members where they are currently and just helping them work towards any sort of health goals they might have in mind, whether it’s better management of some sort of chronic condition, or even just making lifestyle based changes such as working on weight loss or nutrition or exercise. So, there are some similarities and there’s also some differences as well, I guess when you kind of compare them like that.
Host: Gotcha. Thank you. So, now we’ll move into a little bit more on the details, sticking with you, Mr. Plotner. Can you tell us again about health coaching, specifically the services you offer and how it can help people who sign up.
Brian: Yeah, absolutely. So, with health coaching, as I said, it’s really about meeting the members where they’re at. And so some of the things we can do, you know, we can get members connected with resources, ranging from educational information to reaching out and getting them connected with a registered dietician or any other benefits like that, that they may find useful. So, you know, sometimes if somebody has benefits that cover the smoking cessation service, you know, getting them in contact with them is another thing that we can do to help them out. As far as nutrition or exercise goes, I know I mentioned, you know, getting them educational information, whether it’s different recipe ideas, or foods to avoid or, or foods to include more of. And working to kind of structure your portion control better and things like that.
Host: Great, thank you for that. And Ms. Cecil, turning to you, I understand there’s also a program for emotional, mental and behavioral health needs. Can you tell us a little bit about behavioral health care coordination?
Melissa: Sure. So, there’s a few different things that we offer in regards to the behavioral health care coordination program. It is for members who live in Illinois or North Carolina. And if they’ve been discharged from a psychiatric hospital due to having suicidal or homicidal behaviors, mood disorders, anxiety, eating disorders, and or they don’t have follow-up care to manage their behavioral health needs; people who have behavioral diagnoses and would like to work on these goals. So, one of the ways you can self-access by having those things in place, or you may be reached out by a CTI or care transition intervention coordinator, which would follow up on a recent discharge from the hospital and would provide some assistance with discharge instructions, medications, follow up appointments, warning signs, any potential setbacks and available resources. And that pretty much covers what we offer as far as the behavioral health component.
Host: That’s great. It’s great to hear those resources are available. Thank you. And now turning to you, Ms. Noffke. We haven’t even begun to talk about some of the other care coordination programs. Can you tell us a bit about basic care coordination and also care coordination for complex care and specialty care?
Karen: Okay. Well, we have several different care management teams. We have a very high risk that deals with our high-risk members. They actually do in-person, face-to-face meetings with our members and work through care coordination, face to face and telephonically, like some of our other programs. Complex care coordination, again, it’s telephonic. And we work with members with a variety of health conditions. We do some weight loss. We do diabetic management. Sometimes it’s getting someone ready for a procedure, whether that’s a hip or a knee. We also do specialty care coordination. And the focus there is on transplants, end stage renal disease, prenatal and postpartum care, high-risk pediatrics, and NICU babies, oncology and also a behavioral health program. And it, again, it’s a free service for our members and there’s a variety of ways that we reach out to educate our members about their benefit, and they also have the ability to call the health plan and also self-enroll. So, those are just a overview of the programs that we have.
Host: And I understand there are also programs for advanced disease management and for specific diseases and conditions. Can you tell us a little bit about those Ms. Noffke?
Karen: Some of those are focused. People with congestive heart failure, COPD. So, really making sure that our members understand their treatment plan, the things they need to do with congestive heart failure specifically, you know, are they weighing daily? Is that something that’s a part of their treatment plan? Are they watching their sodium intake, are they checking their blood pressures? Are they going to their follow-up appointments, those kinds of things, and setting goals with them. You know, maybe it’s I need to get on that scale every day. And if they qualify, we will actually send them a scale if they don’t have that resource. So, a lot of focused programs around the health condition.
Host: Thank you so much. Such a wide range of services available to help so many different people in so many different ways. So, Miss Cecil, how does someone get started? How do our listeners sign up?
Melissa: Well, if they’re a member of one of our health plans, all they have to do is call the number on the back of their member ID card and ask to sign up for care coordination or health coaching. It’s free help – we’re waiting for them to use – that’s part of the health plan they already have. So, it is at no cost to the member.
Host: Wonderful. Now I really hope more and more people take advantage of these wonderful services, such great personalized help at your side, supporting your own unique health journey. So, just thinking about how many programs you offer and how many ways you can help. I thought it might be best to end with a lightning round of questions so our listeners can get a wealth of information quickly. So, my first question is name one service you offer that’s perhaps unexpected. That is that members probably don’t know about. How about you, Mr. Plotner to start us off?
Brian: Yeah, I mean, honestly, probably the health coaching program as a whole. A lot of people don’t know that they have access to that program just by having insurance through us. And so that, and all of the resources we have, we can share with them, whether it’s education, like I mentioned, or things like a log book to track blood sugars or exercise catalog. There’s a wealth of information that we’re just willing to share with them.
Host: And how about you, Ms. Noffke?
Karen: I think as our members have access to a nurse advisory line. A lot of people don’t ever recognize or notice that they have that it’s on the back of their insurance cards so they can reach out and speak to someone 24 hours a day with a health condition. I find that a lot of people overlook that fact, and it’s a helpful resource.
Host: And how about you, Ms. Cecil?
Melissa: Oh, one thing that we have on our teams are social workers that can provide resources in the member’s own community. As we know, that can be a very stressful situation where maybe they have food issues and having meals delivered to their home, or you know, just offering that kind of expertise from our social worker to help with those resources.
Host: All right. So, next question. I’ll do the same order. We’ll start again with you, Mr. Plotner. Name one type of condition or a situation where again, unexpectedly these services have provided a lot of help.
Brian: Yeah. This one is a little interesting for me coming from health coaching, just because I would say one of the unexpected situations is somebody who maybe doesn’t have a chronic condition at all. So, you know, somebody that just really wants to work on improving their nutrition or work on losing a little bit of weight or getting physically active like they used to be, I think is, is really where the most unexpected.
Host: Gotcha. And Miss Noffke, how about you?
Karen: I think a lot of times our members don’t understand that the providers that they’re being referred to, we need to just verify they are in network or what the resources are in network. And they, believe that everyone’s covered or the doctor wouldn’t send them somewhere where they’re not covered. So, it’s always good to verify the next provider that you’re being referred to and look at your options in network. And I think sometimes people just take it for granted that wherever the doctor’s going to send them is going to be covered. And that’s one thing we can help them with identifying providers that are in their plan.
Host: Yes. And Miss Cecil.
Melissa: Yes, one of the things that I enjoy utilizing is our pharmacy department. Medications can be costly, but they are a great resource to help us identify areas that can assist the member. Or maybe they’re having authorization issues with medications and just not sure what step to take. So reaching out to a care coordinator can be helpful with that.
Host: Well, thank you all so much. For our next question. We’ll do a little elevator pitch. In a sentence or so, why should listeners consider signing up for health coaching or care coordination? We’ll start with you again, Mr. Plotner.
Brian: Yeah, I would say if anyone listening has any sort of health goals on their mind that you’ve been contemplating for a while, get in contact. You know, even if you haven’t really thought about what your first step might be, make us your first step. Get in contact and let us help you make the changes you want to make.
Host: Absolutely. And Miss Noffke?
Karen: It’s a great resource. It’s a free service. If you want to work on your health, health goals or need help coordinating your care between your providers and the health plan, or just help navigating any challenges you’re experiencing related to your health. It’s a great opportunity to partner with us.
Host: Yes. And Miss Cecil.
Melissa: And especially with the background of behavioral health and not going through it alone and having the support of someone who can help you navigate, especially if you’ve never experienced it before.
Host: Wonderful. And okay, our final question, what’s the most rewarding part of your job, Mr. Plotner?
Brian: I think just being able to communicate with people and be able to provide them with the information that they need or maybe they already know and just allowing them to become more in control of their health and giving them the power to really take control of their health through improving their lifestyle changes.
Host: Of course. And Ms. Noffke?
Karen: I, I think like Brian said, you see people take control and have successes, whether that’s losing weight or quitting smoking, people that you’ve assisted with prior authorizations and getting through procedures. And one of the things that I really enjoy is people reach out to you again, when they need assistance. And I, and I think that proves the value of the program to our members.
Host: And Miss Cecil?
Melissa: For me, it’s being able to provide support and empowering them to make those positive health changes really rewards me and, and seeing the end results.
Host: What a great note to end on. Listeners, remember health coaching and care coordination are a free part of your health plan if you’re one of our members and you’ll get a wonderful partner at your side. Maybe even one of our three guests today. To sign up or learn more, simply call the number on the back of your member ID card and ask about care coordination and health coaching.
Why not take advantage of this personalized support, there to help you live your healthiest life? A big thanks again to our three wonderful guests. We’re so grateful for all that you do. And that concludes today’s Hally Healthcast. Tune in next month when we discuss yet another topic important to your health and wellbeing.
And remember Hally health is your partner in helping you live your healthiest life. Visit hally.com for resources, information, tips, and more. Let us help keep you and your family healthy and well. Thanks for listening. We hope you tune in next month.
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