Diabetes Program – Patient Decreased HbA1c
A patient with type 2 diabetes had poor blood sugar control (HbA1c 9.8). The patient received a Continuous Glucose Monitor (CGM) to check their blood sugar levels at home. The patient had challenges using the CGM so the patient was enrolled in the Care Management Diabetes Program in October. Care Management provided the patient with education on medication regimen and blood sugar checks four times daily which was crucial due to the patient’s health. Additionally, the patient was provided education on diet and exercise and referred to a nutritionist in collaboration with Care Management. The patient was mailed an HbA1c home-test kit, and in January the HbA1c was down to 8.1.
Care Transitions Program – From Hospital to Home
A patient was discharged home from hospital after 4-day hospital stay due to Congestive Heart Failure. The patient was discharged home without the portable oxygen supplies they needed and was unsure who to contact. Care Management enrolled the patient in the Care Transitions Program and was able to contact the oxygen supply company and primary care physician to get oxygen ordered.
Care Management was able to help the patient get their oxygen and prevent re-hospitalization through ongoing communication and education with patient, their family, their primary care physician, and heart doctor.