Charleston, W.Va.: The West Virginia Association of Health Plans (WVAHP) announced the winners of its second annual iCare Awards today for services during calendar year 2020. WVAHP is a trade association made up of the managed care organizations (MCOs) that service West Virginia’s Medicaid program. The iCare Awards are given to front line employees of WVAHP member-MCOs who have demonstrated exemplary care and service to West Virginia Medicaid members in helping them achieve positive outcomes in their healthcare delivery.
“Managed care is important to the coordination of appropriate and quality care for West Virginia’s Medicaid members,” said Ben Beakes, executive director of WVAHP. “MCOs are often viewed as workers behind a phone. Most do not realize that our employees are healthcare professionals, social workers, and professional case workers who live in the state and are committed to serving their fellow West Virginians.”
“Medicaid members experienced better outcomes because of the care and commitment of these healthcare professionals. The concerns of our Medicaid members are not all the same; they can be unique, and the solution is not always easy. Each is met with determination and pride by our care managers - a job they enjoy doing,” Beakes said. “WVAHP is proud to honor and recognize the 2020 iCare Award Winners.”
The 2020 iCare Awards recognized the winners for one or more of the following characteristics: innovation, care management, and/or community engagement.
The WVAHP named a grand iCare 2020 award winner. Additionally, an employee from each of the member companies was awarded for two levels of recognition.
iCare 2020 Award Winner: Michelle Tracy, The Health Plan – “A Christmas to Remember”
Tracy assisted a young member who had advanced multiple sclerosis. The condition of the Medicaid member worsened after the birth of her son, despite therapies. In order to treat the member for her symptoms she required travel to the hospital for infusions. Tracy knew the member would not be able to travel five days a week and was able to make other arrangements to accommodate the specific needs of the member. This treatment took place during the holidays and gave the family needed time to be with her. The family sent a note to Tracy to thank her for her efforts, stating, “Because of the medication, care and treatment afforded to her by the team at The Health Plan, we have our daughter back. It is a Christmas miracle.” Watch her story.
Unfortunately, at a later time, the symptoms came back and the member passed away. The family called Tracy to thank her for all that was done. “We are forever grateful for all the help and support you gave us,” the family stated. “We had a Christmas to remember because of you.”
iCare Runner-up Winners: Deborah Livengood, UniCare – “Local Care with the Right Touch”
Leah Eades, Aetna – “Living Independent”
Sheri Meyer, The Health Plan – “Water is Life”
Deborah Livengood had a member whose neurologist suddenly moved to Pennsylvania. The member had asthma, epilepsy, down syndrome, and complications with her medication controlling her seizures. Livengood contacted the Pediatric Neurology Center at WVU and was able to get the member an appointment with the satellite clinic so she did not have to travel great distances to receive care. Livengood coordinated additional services to help with adaptive equipment needed for Middle School. “I strongly feel like this was a win for all of us. The member has a specialist close to home that can see her regularly and resources to assist with school and ongoing health issues”, said Livengood. Watch her story.
Leah Eades had a young member that was trying to transition from drug rehab facility to home. Unfortunately, her environment at home was not supportive of her efforts to refrain from using drugs. Kidd was concerned this may cause her member to relapse, so she began looking into peer support services. The member agreed to these services and has maintained her sobriety while getting her first job and enrolling in college. Watch her story.
Sheri Meyer called a member in hopes of enrolling her into a Disease Management program for her diabetic diagnosis. After speaking to the member over the phone, Meyer learned that her water had been shut off and refrigerator broke. The member was stressed, and Meyer was able to find services to help her in her time of need. Meyer followed up a few days later to find her water had been turned on. The member was more relaxed and Meyer was able to proceed enrolling them into the Disease Management program. “Tending to basic human needs takes priority. Stress contributes to illness and relieving it aids in wellness as well as a person's ability to be receptive to new information,” says Meyer. Watch her story.
iCare Honorable Mention: Annetta Tiller, UniCare – “Fresh Start Kits”
Kayla Sustakoski, Aetna – “Foster Better Services”
Chelsea Sommerville, The Health Plan – “The MCO Family”
Annetta Tiller is a Community Relations Representative with UniCare and works with different organizations that focus on helping fellow West Virginians. Tiller had a project in mind that would help families who were “starting over” due to a disaster. Tiller had her own personal experience with this – a house fire destroyed everything her family had. FRESH START KITS were made and distributed out into the community to organizations like SAFE Domestic Violence Shelter, Communities in School Programs, Parents as Teachers program, and Children’s Home Society. Watch her story.
Kayla Sustakoski had a young member who suffered with behavioral issues due to neglect and abuse, and a diagnosis of ADHD. Sustakoski spoke to the foster parent about applying for waivers that would provide the member with additional services. Sustakoski persistence paid off; the member was able to get the psychological evaluation she needed to complete the waiver process. The waivers were approved, and additional supportive services we delivered. Watch her story.
Chelsea Sommerville, a care coordinator with The Health Plan, refers to her member as a “sweet lady” in need of diabetic supplies. The member was unable to get the diabetic supplies she needed because of past billing issues. Sommerville explained to the member that at that time she was covered under Medicaid with UniCare and the provider must have billed mistakenly. The provider and UniCare worked together to resolve the issue. The member was thankful that Sommerville was able to get the billing issue resolved and received the diabetic supplies she needed quickly. Sommerville said, “also HUGE shout out to MCO Unicare for working with this member to get this resolved. That is what each MCO is about, helping our members in every way possible and getting our members the help they need. It’s an honor to be a part of The Health Plan.” Watch her story.
About WVAHP:The WVAHP is a trade association comprised of West Virginia’s Managed Care Organizations, including Aetna Better Health of West Virginia, The Health Plan, and Unicare Health Plan of West Virginia. The WVAHP was formed in 2016 with the goal to provide assistance to the state of West Virginia in its transition to managed care Medicaid delivery, reduce costs of administering West Virginia’s Medicaid system and improve the health of West Virginia’s Medicaid recipients.