Greater Peoria Metro Area, IL

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Need Help Navigating the Healthcare System?

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By Steven Buttice, Founder and President, Living By Your Design, Inc.

Is it possible to save money on medical expenses and increase the quality of life? Sounds great doesn’t it? Around 1990, progressive people in the medical community put together data that showed if people have help managing their care through the healthcare system, they will not only save money on medical expenses, but also be healthier.

Fast forward to 2018, over the past years this concept has been refined and expanded. Can you imagine having your own nurse with the specific background in your diagnosis? Would this be helpful? Here are the players in the system and how it works:

First, case management also called care management: primarily available to high-risk patients. Examples are COPD, diabetes, heart failure, and other conditions where education and informational assistance could prevent or delay the future progression of the disease. So, if a diabetic takes their medications properly, eats in a healthy manner, and lives a lifestyle respectful of this disease, they may be able to prevent or delay future complications such as kidney failure, heart disease, and more.

You may be asking how this is done. In today’s world, a home visit may be done but also may not be necessary. Video streaming can go a long way for communication. The good, old-fashioned phone call is another tool used. Successful disease control has been shown to not only include medical care, but also diet and environmental factors. A quality air purifier and not smoking may be a good option for COPD patients to remove allergens and germs from the air. A plan for exercise and diet may be suggested. The importance of diet and exercise has been well broadcasted. Removing clutter to reduce falls may also be suggested.

Medical staff: This could be a case manager from your doctor’s office or from a hospital at which you recently had services. The medical staff will go over your medications, your compliance, and medical suggestions with the goal of reducing hospital admissions and continuity of care.

Health insurance companies: They also have case managers. These case managers usually schedule phone times and talk in detail about how you are doing medically and propose ideas that may help you like exercise, diet, and other related factors which play into healthcare. Their goal is to keep a person healthier, thus saving them money.

Can you imagine having a nurse to call if “health things” didn’t seem quite right? You probably already have this help with your doctor’s office.

Private: Imagine having a nurse help coordinate all medical care. These care managers work for you specifically to assist you gathering information on your health, options, setting up services, and advising on what you can do to help yourself. A private care manager, like other case managers, can help save you money in overall costs.

Concierge service: Some doctors have now gone away from private practice into offering a high-level medical assessment, care monitoring, and management of future healthcare service.

Private care management and an MD concierge service are private pay and not covered by insurance. If medical management prevents future complications and medical care, the increase in your quality of life may make this a good value. What if you have diabetes and save a leg, prevent a stroke or a transplant due to the suggestions of a private nurse care manager or concierge service? Isn’t that worth the investment?

For more information, contact Living By Your Design, Inc., focusing on the issues of older Americans: legal, financial, and free guidance for residential placement and healthcare issues. Call 309-285-8088 or visit our website at www.LivingByYourDesignInc.com. We are located at 809 W. Detweiller Dr., Peoria.