Member Case StudyHattie's journey to accessible care with Cleo

Hattie's story

Hattie* is a 74-year-old high-risk member of a Medicare Advantage Plan who lives alone. Despite being well-versed in her health conditions and motivated to manage her care, she faced significant barriers to accessing necessary services.

Due to a below-knee amputation and a recent fall resulting in multiple lower extremity fractures, Hattie uses a power wheelchair for mobility, requiring significant assistance with both Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). She lacked reliable non-medical transportation and struggled to find healthcare providers who could accommodate her powerchair, leading to a dangerous lack of preventative care, including overdue eye and dental screenings. Hattie was also at high risk for falls and was socially isolated due to her limited mobility.

 

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

Getting set up

Hattie connected with Cleo after an inbound referral from her Medicare plan in March 2025. Her assigned Cleo Medicare Coach, Jasmine, immediately recognized the high-risk factors identified in her Health Pulse results, Cleo’s comprehensive assessment that provides a window into physical, mental, social, and healthcare experiences.

On their initial call, Hattie and her Coach established key goals to restore her access to care and enhance her safety:

  • Locate affordable, accessible, non-medical transportation
  • Find in-network providers who could accommodate her powerchair for overdue eye and dental screenings
  • Obtain a Personal Emergency Response System (PERS) due to her substantial fall risk
  • Reestablish home health physical therapy (PT) services to regain function
Cleo Guide

Securing care

Hattie’s Coach focused on removing the systemic and logistical barriers that prevented her from getting care. The coaching plan centered on educating Hattie to advocate for her needs and delivering high-value interventions to ensure safe, affordable, and accessible services.

Enhancing safety and mobility

To address her fall risk and mobility goals, the Coach focused on providing resources for physical safety and rehabilitation.

  • The Coach worked to get an order for home health services, enabling Hattie to reestablish home health PT within two weeks, setting her on a path to graduate to outpatient therapy.
  • A PERS device (Medical Alert) was successfully set up for Hattie.

Ensuring affordable and accessible screenings

Hattie had previously been billed for services due to provider inexperience with powerchair accommodations, and she was concerned about cost.

  • Vision & Dental: The Coach successfully assisted Hattie with getting her initial eyecare claim reversed, which allowed her to complete a full vision exam at a wheelchair-accessible provider. She also located an INN dental provider with free-standing equipment, enabling a complete exam and necessary tooth extractions.
  • Bone Density Scan: Hattie’s provider initially scheduled her bone density test at a hospital, which would have resulted in an out-of-pocket co-pay she couldn’t afford. The Coach located an INN office imaging center and facilitated a conference call to have the order resubmitted. This resulted in the member completing the testing with no out-of-pocket cost.

Fostering independence

Recognizing Hattie’s strong motivation to increase her social engagement, the Coach addressed her lack of transportation.

  • The Coach helped Hattie complete an application with a community resource for non-medical transportation. The resource allows a caregiver to ride along, enabling Hattie’s sister to assist her during outings like shopping and banking.

Success metrics achieved

Through bi-weekly check-ins and high-value interventions, Hattie was able to overcome significant health and accessibility hurdles, achieving all of her initial SMART goals.

  • All Key Screenings Completed: Annual vision exam (corrective lenses obtained), annual dental exam (extractions completed), and bone density scan completed.
  • Safety in Place: PERS device (Medical Alert) installed and active.
  • Mobility Restored: Home health PT services resumed, paving the way for future outpatient therapy.
  • No Out-of-Pocket Cost: Completed bone density testing without any co-pay, avoiding financial strain.

Health & quality of life improvements

 

  • Pain Relief: No longer has pain while eating due to successful tooth extractions, reporting an increased quality of life.
  • Improved Vision: Reported satisfaction with corrective lenses and was pleased that her full eye exam included an assessment of her optic nerve.
  • Increased Independence: Utilized non-medical transportation for shopping and banking, reducing social isolation.
  • Enhanced Trust: Reported high satisfaction with her new providers and plans to continue the relationship.

 

health pulse - eldercare and medicare advantage population

Empowerment and support

Hattie’s Coach reinforced talking points for navigating future care providers to ensure they can accommodate her powerchair, empowering her to manage her long-term care needs. Hattie expressed immense gratitude for the support and stated how “amazing” it was to have Cleo “checking in on her.” Demonstrating her satisfaction, she persuaded her sister to enroll in the health plan and Cleo during the next qualifying open enrollment period.

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