Driving back costs by getting in front of chronic illness

Casey lives in North Carolina. She also has diabetes. When she was diagnosed, her heart sank. Diabetes wasn’t new to Casey – she had family members with the disease and had seen firsthand the toll it took on them, physically and financially. So, she changed her diet. She exercised four times a week. She tried intermittent fasting. But nothing seemed to work.

There are tens of thousands of North Carolinians suffering from chronic illnesses like Casey’s. Diabetes, cancer, heart disease, traumatic injuries – these conditions are devastating for individuals and their loved ones. They’re also extraordinarily expensive.

People with chronic conditions account for 90% of the nation’s $4.1 trillion health care expenditure annually. They require frequent doctor visits, expensive medications, and time off work. These conditions invade not only their body, but their lifestyle. It occupies their minds and demands constant attention to their bodies. And when it gets one step ahead of them, the results can be grave – and costly.

This is why Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has a team of Nurse Care Managers who can step in to counsel and support members between doctor visits. They answer questions, direct members to resources, and save them time, stress, cost, and trips to the ER.

Casey: Real-time data, real progress

Casey¹ couldn’t get her diabetes under control; she called the Nurse Care Manager hotline and was connected to Shirlene. Shirlene listened to Casey’s story and suggested a continuous glucose monitor (CGM) to give Casey real-time feedback on how meals were affecting her blood sugar, without the constant finger pricks. Casey was able to adjust food choices, lost 18 pounds, and saw a drop in her A1C⁠ levels.

“Often, members have a sense of what they need, but they’re not sure if they qualify or how to get started,” Shirlene says. “That’s where we step in to guide them and simplify things."

Cheryl: Closing gaps before crisis

Cheryl, another Nurse Care Manager, started her medical journey in cardiology, followed by rehabilitation, urology, and neurology – each unit giving her the tools to understand complex medical conditions. When she met Leo¹, who was edging towards an emergency without his diabetes medication, she knew what to do. Cheryl connected him to nutritional support and secured the medication.

“It’s not just about treating a condition,” Cheryl explains. “It’s about closing gaps in care and making sure nothing falls through the cracks.”

Ronnie: Trust first, care follows

Ronnie¹ needed to overcome several hurdles. Living alone with agoraphobia⁠, he had withdrawn from the world, stopped seeing his cardiologist, and was experiencing dizziness and fatigue from heart disease. Kayla, a Nurse Care Manager, was able to gain his trust and convinced him to see a doctor to adjust his medications and resolve his symptoms. She explained how his smoking was spiking his blood pressure. And, because Ronnie trusted her, he quit cold turkey. He lost weight, gained energy, and began venturing outside the house to enjoy hobbies he had given up years ago.

“Building trust is everything,” Kayla says. “It’s about validating someone’s feelings, listening without judgment, and meeting them where they are.”

Dave: Safety, confidence, and independence

Dave’s¹ life was also transformed by a Nurse Care Manager. When he met Jacquovia he was suffering on several fronts. A traumatic brain injury was preventing him from doing things as seemingly simple as taking a bath. He lived in fear of falling at any moment and didn’t have transportation to see his doctor.

Jacquovia coordinated transportation to medical appointments and helped him order home-safety devices – benefits provided through his Blue Cross NC plan. This proved to be life-changing for Dave, who could move with confidence and dignity through his day-to-day.

"Many of our members don't realize how many benefits their plan includes," Jacquovia says. "We help them understand their options, from getting a gym membership to accessing affordable medications through patient assistance programs."

More than medical help: A human connection

Blue Cross NC’s Nurse Care Managers work on the frontlines to make sure members have what they need to stay healthy, save money, and find support.

Through Blue Cross NC’s Nurse Care Manager team, members can find support for managing their medications, transportation, meal deliveries and scheduling doctor’s appointments. But even more than that, they’ll find a human on the other end of the line who is there to walk with them every step of their journey.

Call a Nurse Care Manager to get the right help at 800-218-5295 – Monday through Thursday 8 AM–7 PMET and Friday 8 AM–5 PMET.