A Medicaid Journey

AmeriHealth Caritas Louisiana care manager guides a member back to health.

In July 2012, Karen Thompson noticed a lump on the roof of her mouth. Her job did not provide health insurance, but she sought help from the only doctor in her small parish.

She went for a consultation at Louisiana State University in Shreveport. A biopsy confirmed oral cancer. The tumor had to be removed.

It was a 12-hour operation. Over the next six months, Karen would undergo both chemotherapy and radiation. The surgery left her with a quarter-sized hole in the roof of her mouth. For months she’d been receiving nutrition through a feeding tube in her stomach.

Karen had to leave her job and seek Medicaid coverage. She joined AmeriHealth Caritas Louisiana in February 2013.

Karen Thompson
Karen Thompson

Kevin Brown, nurse care manager with the Rapid Response team, remembers learning Karen's story. "Karen couldn't find an oral surgeon who would build an appliance to block the hole for less than $7,000," he says. “She was down from a healthy 135 pounds to just about 100 after treatment."

The next morning Kevin called Karen. He had a dentist appointment set for her in Baton Rouge.

Along with a team of care connectors and provider network specialists, Kevin continued to coordinate Karen's care. Over the next several weeks, an oral surgeon fit her with a custom dental appliance.

The road to health

Karen had been driving hundreds of miles to see her doctors. Kevin told her about the plan's mileage reimbursement program, which allowed her to buy new tires for her car.

Since then, Karen has gained more than 20 pounds. "I'm out power walking five miles every day," she says. "And I’m looking for a job now that I'm healthy again. I want to be able to help people like Kevin helped me."

"Karen is exactly the kind of person that Medicaid coverage really helps," says Kevin. "She's worked all her life, raised three kids, and put a daughter through college…It wasn't until Karen's health reached a crisis point that she needed assistance.

"It takes all of the AmeriHealth Caritas Louisiana team to chip away at the barriers our members face to make real progress."