Disease & Care Management

Sometimes you need a little extra help. A care manager is here to be your advocate. Care managers are nurses or social workers who are trained to help you understand your health condition and get medical and mental health care you need. They also can connect you with other local resources.

A care manager is available to educate and help members understand their medical problems and healthcare needs. This includes:

  • Perinate needs; medical advise or help needed during your pregnancy.
  • Members with special needs; such as asthma, diabetes, sickle-cell or physical disabilities.
  • Proper use of the ER; such as a bone is broken, severe injuries or burns. 
  • Behavioral health needs; such feeling depressed, alcohol or drug abuse.

They will also:

  • Offer coordination and collaboration of health care needs
  • Provide you with information on resources
  • Offer education on your benefits
  • Help with authorizations and referrals

Care managers will help you:

  • Find a primary care provider
  • Schedule doctor’s visits
  • Find specialists, such as psychiatrists, therapist, skilled-nursing facilities and more

Care managers can work with you to:

  • Get any medical equipment you need
  • Contact Medicaid or CHIP for you
  • Arrange for rides to your doctor, the drug store or the hospital

Want to learn more? Call Member Services and ask for Care Management:

Parkland HEALTHfirst at 1-888-672-2277
Parkland KIDSfirst at 1-888-814-2352

Asthma affects people in different ways. In some people it is worse, and they have a lot of trouble breathing. Others do not have as many problems. If you have asthma, the important thing is to discuss your case with your doctor. We are here to help.

If you are low risk, we will give you information to help you take care of yourself.

If you are high risk, a health coach or case manager will call you to talk about your care. Here are some things the health coach or case manager will talk about with you:

  • Taking care of your asthma at home
  • Why taking your medicine is important
  • What causes asthma attacks
  • Why you need to do what your doctor tells you
  • Ways to change your habits so you feel better

It’s important to learn as much as you can about your asthma.

If you want to learn more about Parkland Community Health Plan’s asthma management program, call Member Services toll-free at 1-888-672-2277 or 1-888-814-2352. Ask to talk to an asthma care manager.

 

People with diabetes have too much sugar in their blood. If you have diabetes, we can help you manage it better. Without treatment, you could develop major health problems, like heart disease. Diabetes also can severely affect your eyesight.

Some people have mild diabetes. They take care of it by exercising and eating healthy foods. Other people have diabetes that is more serious. They have to take shots of a hormone called insulin. Insulin helps your body's cells use food the right way. Everyone with diabetes needs care from a doctor.

We have a Disease Management Program for members with diabetes. Tell your doctor and us if you have diabetes. Call us if your doctor tells you that you have diabetes. We will work with you to see if you are at low risk or high risk for problems.

If you are at low risk, we will give you information to help you care for yourself. Also, we will work with your doctor to get you the right care.

If you are at high risk, a health coach or case manager will call you to see if you need more help.

We can teach you about diabetes and help you take care of yourself. You will learn:

  • How to take care of your diabetes
  • How to watch your blood sugar
  • Why you need to take your medicine
  • How to take good care of your feet
  • Why you need to do what your doctor tells you
  • How to learn healthy habits so you feel better

We can also assist you in scheduling your annual diabetic eye exam and annual foot exam. It is important to learn as much as you can about your diabetes.

If you want to learn more about Parkland Community Health Plan’s diabetes management program, call Member Services toll-free at 1-888-672-2277 or 1-888-814-2352. Ask to talk to a diabetes care manager.

Resources: American Diabetes Association

Cold and Flu

The common cold and influenza commonly called “the flu” are infections that affect your respiratory tract (the mouth, nose and lungs, and the passages between them). Unlike a cold, the flu can make you very ill. It can lead to pneumonia, which is a serious lung infection. For some people, especially older adults, young children and people with certain chronic conditions, the flu can have serious complications and can be deadly.

Anyone can get the flu. But you’re more likely to become infected if you:

  • Have a weakened immune system
  • Have frequent, close contact with young children
  • Work in a health care setting where you may be exposed to flu germs
  • Live or work with someone who has the flu
  • Haven’t received an annual flu shot

Viruses. Viruses spread through the air when someone who has the flu coughs, sneezes, laughs or talks. When you are near that person, you can become infected when you breathe the same air. You can also become infected when you touch a surface that person has touched. You then transfer the germs to your eyes, nose, or mouth. Don’t touch used tissues, or share utensils, drinking glasses or a toothbrush with an infected person. That can expose you to flu viruses, too.

Flu symptoms tend to come on quickly and may last a few days to a few weeks. They include:

  • Fever -- usually higher than 101°F  (38.3°C) -- and chills
  • Sore throat
  • Headache
  • Dry cough
  • Runny nose
  • Tiredness and weakness
  • Muscle aches

Flu usually improves on its own. In some cases, your doctor may prescribe an antiviral medication. This may help you get well sooner. For the medication to help, you need to take it as soon as possible after your symptoms start. If you develop pneumonia or other serious illness, hospital care may be needed.

  • Drink lots of fluids such as water, juice and warm soup to prevent dehydration. A good rule is to drink enough so that you urinate your normal amount.
  • Get plenty of rest.
  • Ask your doctor about acetaminophen (Tylenol) or other medications for fever and pain. Take medication only as directed. Don’t give aspirin to children under age 18. It can cause a rare but serious illness called Reye’s syndrome.
  • Call your doctor if your fever rises above 101°F (38.3°C) or you become dizzy, lightheaded or short of breath.
  • Wash your hands often, especially after coughing or sneezing. Or, clean your hands with an alcohol-based hand gel containing at least 60 percent alcohol.
  • Cough or sneeze into a tissue. Then, throw the tissue away and wash your hands. If you don’t have a tissue, cough and sneeze into the crook of your elbow.
  • Stay home until at least 24 hours after you no longer have a fever or chills. Be sure the fever isn’t being hidden by fever-reducing medication (such as ibuprofen).
  • Don’t share food, utensils, drinking glasses or a toothbrush with others.
  • Ask your doctor whether others in your household should receive antiviral medication to help them avoid infection.
  • One of the best ways to avoid the flu is to get a flu shot each year. Flu viruses change from year to year. For that reason, doctors recommend getting the flu vaccine each fall or winter. Most often, the vaccine is given as a shot. But some people may receive the vaccine as a nasal spray instead. Your doctor can tell you which vaccine is right for you.
  • Wash your hands often. Frequent hand washing is a proven way to prevent infection.
  • Carry an alcohol-based hand gel containing at least 60 percent alcohol. Use it when you don’t have access to soap and water. Alcohol gels kill most germs and are safe for children.
  • Avoid touching your eyes, nose and mouth.
  • At home and work, clean phones, computer keyboards and toys often with disinfectant wipes.
  • If possible, avoid close contact with others, especially children.

 

If you’re 65 or older, smoke or have a chronic health condition, ask your doctor if you should receive the pneumonia vaccine.Click on the Plan name below for more information on how to enroll.

For some people, the flu can be very serious. The risk of complications is greater for:

  • Children under age 5
  • Adults 50 years of age and older
  • People with a chronic illness, such as diabetes or heart, kidney or lung disease

People who live in a nursing home or long-term care facility

Hand washing is one of the best ways to prevent many common infections. If you’re caring for or visiting someone with the flu, wash your hands each time you enter and leave the room. Follow these steps:

  • Use warm water and plenty of soap. Work up a good lather.
  • Clean the whole hand, under your nails, between your fingers and up the wrists.
  • Wash for at least 15 seconds. Don’t just wipe — scrub well.
  • Rinse, letting the water run down your fingers, not up your wrists.
  • Dry your hands well. Use a paper towel to turn off the faucet and open the door.

Alcohol-based hand gels are also a good choice for cleaning your hands. Use them when you don’t have access to soap and water, or your hands aren’t visibly dirty. Follow these steps:

  • Squeeze about a tablespoon of gel into the palm of one hand.
  • Rub your hands together briskly, cleaning the backs of your hands, the palms, between your fingers and up the wrists.
  • Rub until the gel is gone and your hands are completely dry.