Charleston, W.Va.: The West Virginia Association of Health Plans (WVAHP) announced the winners of its inaugural iCare awards today in a ceremony attended by WVAHP members and officials from the West Virginia Department of Health and Human Resources’ Bureau for Medical Services. 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. During the month of August WVAHP solicited responses to an online questionnaire open to employees of member companies. The questionnaire was designed to collect personal stories of successful outcomes for Medicaid members with which the employee had a hand in facilitating. Each response was validated prior to selection of the winners.
“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.”
The Winners
The WVAHP named a grand iCare 2019 award winner. Additionally, an employee from each of the member companies was awarded for two levels of recognition.
iCare 2019 Award Winner: Amanda Poole, UniCare – “Angel Lady”
In her response, Poole reflected on what it means to her and those she helps navigate the healthcare system to get the services they need. “There is nothing more satisfying than a parent’s appreciation of a call to check on their child, or an ear to listen when they have concerns, or a helping hand when they are filled with confusion,” Poole said. “I have one mother who refers to me as her ‘angel lady’, what a wonderful feeling knowing that I can make that big of a difference in her life and that of her daughter’s.”
Poole was particularly involved in one case relating to a 15-year old girl who had a rare illness that struck her quickly. The girl was active in sports and her illness left her paralyzed from the neck down, requiring a ventilator for breathing support. After receiving her case, Poole worked alongside her parents and the hospital to get her transferred to a specialty inpatient rehab facility. The girl has making remarkable progress – standing and walking short distances. Poole continues to stay in contact with the family. Her father expresses gratitude to Poole with every conversation.
iCare Runner-up Winners: Leigh Rice, Aetna – “Horse Therapy”
Debra Azallion, The Health Plan – “Crib for Child”
Rebecca Tate, UniCare – “Ambulance checks on the Homeless”
Leigh Rice had a child member who was traumatized by witnessing his mother’s illnesses (brain tumors). He refused to go to school as he was worried something would happen to her while he was gone. The boy was introduced to a group who uses horses in their therapy. Unfortunately, the group was not a participating provider in the Medicaid plan. Rice worked with the provider to get them certified to become a participating provider in the network so the boy could continue his care.
Debra Azallion had a case of an eight-year-old girl who had a rare disease. The girl had been in and out of the hospitals her entire life and never grew past the size of an 18-month old baby. After one hospitalization the hospital ordered a crib that needed to elevate at the head. No medical device company had the crib available. Azallion utilized her network of contacts and found a local hospital that had one. She made alternative arrangements for the parents to pick up the crib and use it at their home.
Rebecca Tate created a program with the local Ambulance Authority to check on certain Medicaid members who were homeless. Many case managers fulfill the role of reminding members when to take medication and ensure they are following the care instruction given to them by their physician. Due to this program, one particular member changed his healthcare behavior, began utilizing his medications regularly, and now has been able to find a home for himself.
iCare Honorable Mention: Bethany Ferris, Aetna – “NAS Baby gets Better”
Jeanetta Williams, The Health Plan – “From Medicaid to Case Manager”
Melissa Pauley, UniCare – “Rural Services”
Bethany Farris was able to arrange care for a baby with Neonatal Abstinence Syndrome who had was under the care of two foster parents. Jeanetta Williams used to receive services from Medicaid, but now uses her experiences to help others as a case manager for The Health Plan. Melissa Pauley arranged for in-home training on how to care for a wound for a member who had no transportation and lived in a remote area of West Virginia.
“Today we have awarded some exemplary servants in our managed care organizations,” Beakes said. “But the true winners are the individuals that were served by these employees. They saw better health outcomes because of the intervention, ingenuity, and dogged commitment of MCO professionals.”
“Navigating healthcare can be confusing and scary. The managed care model is designed to help members find appropriate services with partner providers who deliver quality care,” Beakes said. “Our MCO members are proud of the partnership they have with the State of West Virginia and take seriously the delivery of care to our Medicaid members. Further, we are proud of the sacrifices and service our iCare winners exemplify – we are proud of them and all of the employees at our member companies.”
Additional Quotes from Submissions
It gives me great satisfaction knowing that I am in a position where I can make a difference and able to connect with others who have been in the same situation as myself. Coming to work every day makes my heart happy because I know that I am making a difference in someone’s life one step at a time. – Jeanetta Williams, The Health Plan
Being a part of a managed care setting as a healthcare professional means you can work with a variety of people with unique skill sets, all engaged in meeting a common goal – to help others become healthy. With collaboration of so many different professionals with varied backgrounds, we can utilize our knowledge and experiences to bring ideas to the table that perhaps haven’t been tried before. I feel our members appreciate the devotion we show as we work with them to find solutions to their biggest medical concerns. – Bethany Ferris, Aetna
West Virginia is my home and, though we may have challenges, I feel I am doing my part by reaching out to our members, helping them to see their own potential to stay healthy and encouraging them to seek out the assistance they need. – Melissa Pauley, UniCare
I absolutely love my job. I had always worked on the front lines in healthcare and was very hesitant to take a job in insurance, thinking that I would not have an impact on my members – but I was wrong. – Debra Azallion, The Health Plan
I strive to provide the best care to my fellow West Virginians every single day I step into my office. These members are a part of my community, and if I am not helping to make my community better then I feel I have failed - not only as a nurse, but as a West Virginia resident. – Rebecca Tate, UniCare
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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.
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