Member Case StudyAlma's journey to pain-free mobility with Cleo

Alma's story

Alma* is a 68-year-old member of a Medicare PPO. While she had strong protective factors—including medication adherence, completed screenings, and social support—Alma faced a significant health hurdle that was stalling a crucial surgery and severely impacting her quality of life.

Alma struggled with chronic pain, difficulty walking due to metatarsal deformities and right hip pain, and a history of falls. Her Orthopedic surgeon recommended a hip replacement, but she was categorically denied approval until she achieved a 15-pound weight loss. This requirement created a cycle: chronic pain and difficulty walking made exercise impossible, and self-reported poor eating habits made weight loss difficult. She also experienced anxiety, depression, and difficulty with IADLs (cooking, cleaning, shopping).

Her immediate motivation was clear: “I just want to be able to walk around with my daughter and grandchildren.”

*Names haves been changed to protect the identity of the member.

Getting set up

Alma connected with Cleo Medicare Coach, Jasmine. Her initial Health Pulse indicated a Medium Risk status, driven by her physical health challenges and weight-related barrier to surgery. The coaching strategy was immediately focused on developing a feasible weight loss plan that worked around her severe pain.

Focus Areas: Finding suitable exercises; locating an INN dietician for weight loss and fatty liver disease management; and setting up the supplemental fitness benefit.
SMART Goals: Speak with PCP for clearance for seated exercises; complete seated exercise via streaming service 2x per week once cleared; implement dietician recommendations into at least 1 meal per day.

Securing care

The long-term coaching strategy was focused on creating sustainable, incremental lifestyle changes to achieve the 15-pound weight loss required for her hip replacement, while also leveraging her health plan benefits. The Coach set bi-weekly check-ins to monitor diet and activity progress.

Removing the weight barrier to surgery

The Coach implemented a two-pronged approach focusing on activity and nutrition that accommodated Alma’s pain:

Modified Exercise: The Coach immediately enrolled Alma in the supplemental fitness program. She then identified seated exercises that Alma could complete safely without increasing her pain, working around her inability to stand.
PCP Clearance: The Coach helped Alma develop talking points to discuss with her PCP to ensure the new, seated activity level was safe and medically effective. Alma received high quality care during her PCP visit for exercise clearance.

Targeting nutrition and chronic condition management

To address the core issue of weight and her poor eating habits, the Coach leveraged a health plan benefit:

The Coach located an INN dietician to promote Alma’s understanding of healthy meal options to manage her fatty liver disease and support her weight loss goal.
Alma implemented the dietician’s meal recommendations into her daily meal planning.

Success metrics achieved

Through consistent coaching focused on small, achievable daily changes, Alma achieved her weight loss goal in just 1.5 months, allowing her to proceed with the critical hip replacement surgery and begin her path to pain-free mobility.

Surgical Clearance: Member met the 15-pound weight loss goal after 1.5 months.
Mobility Restored: Member was able to ambulate with a walker post-surgery.
Goal Sustainment: Continues to participate in seated exercises and implement dietary changes.

Health & quality of life improvements

Surgical Success: Member was able to have hip replacement surgery in June 2025.
Increased Activity and Health: Member reported she was able to apply dietary changes into her daily routine, which she said increased her activity levels.
Increased Independence: Member reports increased ease with IADLs (cleaning, cooking, shopping) and is actively working with PT/OT to continue progressing her strength and mobility.

Empowerment and support

By creatively locating modified exercises and connecting Alma with essential nutritional counseling, the Coach broke the cycle of pain and inactivity. This targeted support led directly to the successful hip replacement, fulfilling Alma’s vision of being able to walk with her family again.

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