Member Care Advocacy Leads to Personalized Healthcare Done Right!

In this case, our Member Care Advocate coordinated care needs on behalf of a patient in the face of a national backorder. The advocate took every action to ensure their healthcare needs are met with no delays in diabetes therapy–the patient was not left to quarterback her own healthcare needs.

“They worked tirelessly, even after hours as we were on different time zones, to make sure my daughter would get the device and supplies she needed… I will forever be grateful for their help”

– Patient’s mother

Recognizing there are patients with healthcare or service complexity in every employee population, we built a complex care management model specifically to identify these patients for clinical concierge services. Member Care Advocacy is our team of pharmacy technicians that provides a consistent, compassionate care experience to help reduce gaps in care and promote a better quality of life.

In this case, a 23-year-old patient with diabetes and her parent were unable to obtain her prescription diabetes management device and associated supplies due to a national backorder. This patient is insulin-dependent and without a working pump, faced serious health risks. When the family contacted us, we took immediate action. The Member Care Advocate followed three plans of action behind the scenes to relieve the burden on the member. The advocate worked directly with the manufacturer to gauge shipping supplies from their facility, contacted a local participating retail pharmacy, and communicated with the mail order pharmacy to determine a solution that avoided further delay in therapy.

The mail order pharmacy was able to dispense the supplies most quickly. As a cohesive care team, the Member Care Advocate and EmpiRx Health Clinical Pharmacist expedited and streamlined care coordination to ensure the prescription was issued the same day. The Member Care Advocate kept the member and her parent informed of steps that were taken to reassure them that the supplies would reach them as quickly as possible.

Our model ensures that the member receives a high-touch clinical concierge service experience in their healthcare journey. The Member Care Advocate is a care navigator between the member, prescriber, and pharmacy, and conducts consistent outreach to ensure the members are doing well or if they require any additional support.

Clinical outcome:
Avoided interruption in diabetes therapy―the patient was not left to quarterback her own healthcare needs.

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