How SHS Managed Care Is Working for You

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Lindsey Carillo

The phones in Lindsey Carrillo’s offices are getting a workout these days.

Lindsey Carrillo, Manager of SHS Managed Care, and her team are working their way through a list of more than 14,000 area residents who are assigned to Swope Health Services for medical care under Medicaid.

Some are patients who previously visited SHS, some might need ongoing care for chronic health issues. Others have never visited but could, based on their insurance coverage.

“I want to invite patients to come here for their primary care services and encourage them to come in before they are sick,” Lindsey said. “It’s important to build a relationship with your medical team. Oftentimes when medical issues are caught early, providers are able to treat them, decreasing the chances of a serious condition.”

Jo Brown and Veda Green are two full-time care navigators focused on extending those personal invitations. Since September 2016, they’ve made more than 20,000 phone calls and sent 6,000 letters and postcards.

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Jo Brown

The outreach is working. Lindsey notes the team has brought in 445 Medicaid managed care patients who had not been seen in 2016. The group also has scheduled more than 1,460 appointments for various other reasons.

Each call is a little different, depending on each caller’s needs.

The care navigators ask patients why they haven’t been in, and they hear a variety of reasons: no transportation, no time, location isn’t convenient.

They work through the issues, offering access to transportation services, assisting with scheduling, finding an SHS location that’s closer.

One woman had been hospitalized 46 times in the past two years. She didn’t realize she could’ve been coming to SHS to see a primary care provider regularly.

Now, with ongoing care of her chronic issues, her chances of avoiding emergency room services or hospitalization are improved.

Another time, Jo called to remind a patient of an appointment. The man had been alone and was distressed by a death in the family. He needed help, and Jo’s call brought him in for a variety of services.

“He’d never had anyone call to check on him,” she reported. “I was glad we did.”

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Veda Green

Not all the phone calls reach the intended patients, Lindsey added. Another time, Veda called and got a wrong number – but the person who answered the call was interested and needed healthcare services. Veda helped her get an appointment, too.

The calls often include facts about how to prepare for a visit, explaining what to bring and describing the examination and labs process.

The team helps schedule appointments and even makes reminder calls, which helps cut down on missed appointments and keeps patients eligible for advance scheduling.

“Providing quality care is important to us,” Lindsey said, “and part of that is getting patients in for their follow-up appointments.”

The managed care team works closely with area insurance programs, including Aetna Better Health, HomeState, UnitedHealthcare and Missouri Care.

All insurance companies prefer keeping patients healthy with regular visits to a primary care provider. The ultimate goal is to reduce hospitalizations and emergency room visits while making sure patients are receiving quality ongoing care.

So, if you happen to get a call from SHS, please listen. It might just be Jo or Veda or Lindsey, calling with a personal invitation for YOU to come in to take care of your health.

Consider this your invitation! Call 816-599-5840 to schedule an appointment and develop a healthy relationship with SHS.