Creating a better experience for Medicare Advantage members
Navigating any healthcare journey is stressful and often frustrating – and that’s especially true for members dealing with the complicated Medicare Advantage system. Without personalized support from a team of experts, members often struggle to make the right decisions.
Explore how one member’s real-life journey would have improved drastically with 1:1 guidance from Quantum Health’s team of empathetic Healthcare Warriors®.
• 93 years old
• Lives in Ohio, spends summers in Florida
• Type 2 diabetic with history of bladder cancer
See how Gordon's real-life journey would have gone differently if he'd been guided by Quantum Health's team of experts
Gordon experiences symptoms consistent with stroke and goes to ER in Florida.
After being admitted to hospital, his symptoms lessen and family advocates for testing unrelated to stroke.
After lengthy delay, test reveals blood glucose levels in the 400s.
A1c has been near 10 for several months, indicating his diabetes was not being controlled by his Metformin and Januvia prescriptions.
Uncontrolled diabetes determined as the reason for his symptoms – no sign of stroke.
After discharge Gordon visits a new endocrinologist, who prescribes Victoza (a GLP-1), a new prescription for insulin and a new continuous glucose monitor (CGM) sample.
With Quantum Health
Rather than make a confusing medication switch, Gordon would have been advised by our team of clinical experts to maintain adherence to his prescribed treatment plan and connect with his PCP for next steps.
After three months using the GLP-1, Gordon has lost his appetite and 30 pounds.
With Quantum Health
Instead of feeling isolated, Gordon would receive regular check-ins from a dedicated nurse, who would have helped him manage appetite loss and identify earlier opportunities for intervention with his lack of blood glucose control.
Around the same time, samples ran out for his CGM.
Struggling to understand what was needed and unable to get clarity from pharmacy or PBM, he paid out of pocket for his new device – even though it was a covered benefit.
His GLP-1 becomes increasingly hard to find and fill, resulting in multiple weeks of missed medication.
With Quantum Health
Instead of struggling with his CGM or wondering when his next GLP-1 fill would occur, Gordon would have made a single call to Quantum Health to get things straightened out.
Luckily, Gordon had medical professionals in his family to guide him back to his PCP in Ohio.
PCP resumes Metformin and Januvia prescriptions with minimal basal insulin, and Gordon regularly monitors his blood sugar and remains focused on nutrition.
With Quantum Health
Surrounded by a team of empathetic Healthcare Warriors advocating for him every step of the way, Gordon’s would have:
- Better managed his diabetes and likely avoided an ER visit and hospital admission
- Saved money by not paying out of pocket for a covered prescription
- Felt healthier and maintained his weight and appetite
