Molina Member Story

Molina's Specialty In Care Gains Trust Of member And Puts His Health Back On Track

John is a 45-year-old man who lives with hypertension, asthma, TIA, diabetes and ESRD. John has a history of discharging himself from hospitals against his team’s medical advice. John has a history of nonadherence to prescribed medications and not going to follow-up appointments. John is not established with any primary care or specialty providers. John was referred to Molina case management during an inpatient stay for TIA, cardiac event and seizure like activity. John was prescribed insulin during his stay and received hemodialysis.

John worked with his case manager, who has a specialty in diabetes management. The case manager engaged with hospital staff, John’s daughter, and the support team to help support John’s recovery. The case manager provided John with support and education on disease management, as  well as a discharge plan to help meet his needs. John was discharged and needed 24-hour supervision. John’s case manager continued to provide support services post discharge.

The case manager arranged for support, scheduled follow-up appointments, transportation, provided education on disease management, medication management and was referred for HCBS waiver support. The case manager also helped John get a cell phone and blood pressure cuff. Now, John sees his nephrologist regularly and gets regular blood work. John uses Molina’s transportation services to get to and from his  appointments. John no longer requires dialysis and is medication adherent. He does not require insulin and tracks his blood pressure daily. John has returned to work as a high-school janitor and lives independently.