HealthSpring nurse practitioner identifies impending heart attack

Feb 6 2010

Olive Branch, Miss. resident Glenn Lusk has a special perspective on the value of his Medicare Advantage plan. It was a HealthSpring-contracted nurse practitioner who discovered during a home visit in November that Lusk was experiencing serious heart trouble.

“Mr. Lusk’s story is encouraging, because it tells us we really are making a difference by proactively sending care out to members”

“Somebody up above was looking out for me,” Lusk said.

Nurse practitioner Lucretia Daniel was concerned with the symptoms she observed in Lusk. “I said, ‘You know, I really think this is your heart. I think we need to send you to the ER to get this checked out.' I knew there was a high probability that there was something that was going on. He had been dealing with this for three days and hadn’t gone in. He thought it was just his blood pressure.”

Daniel was at the Lusk home as part of HealthSpring’s “360 Physical” program. The 360 Physical brings nurses to members’ homes for thorough physical check-ups to help monitor their health and catch potential problems early.

Glenn Lusk took his visiting nurse’s advice seriously. “She said normally she would call an ambulance. But I immediately got dressed, and my wife took me to the hospital.”

“They ran their usual tests and gave me nitro[glycerin] immediately. Thirty to 45 minutes later, a doctor came in and said, ‘Yeah, you’ve had a heart attack.’”

Lusk was quickly taken into heart surgery. “About 5 to 6 years ago I’d had two stents put in,” he said. “Those had collapsed or stopped up. They were able to clean those up and put two new stents in. I didn’t have to have open-heart surgery, so I was extremely lucky.”

The doctor confirmed after the surgery that Lusk had experienced a full heart attack. His care providers told him his heart’s capacity had dropped from 65 percent before the attack to 45 percent afterward, Lusk said. “Within a year’s time, with diet and exercise, I can gain that back.” He does not intend to waste time getting started on that goal and has already dropped 20 pounds, he said.

Lusk is very thankful the HealthSpring nurse was in his home at the right time to catch the problem and send him for medical care.

“The whole thing was very lucky with the timing,” he said. “You never know, everything is subjective, but if she hadn’t been here or if it hadn’t been detected at that time, I probably would have had a worse attack. It’s all conjecture, but it all worked out for the best. I guess it was meant to be.”

Lucretia Daniel is also thankful she was at the Lusks’ home at the right time. “I felt good about it, but more importantly, I was so glad that he was okay. I was really concerned about him, I really was,” she said. “I had been an NP [nurse practitioner] in the emergency room, and these are the types of results that you want to have.”

Daniel values her role with HealthSpring’s 360 Physical program. “I felt like this is what I’ve always wanted to do,” she said. “I get to actually sit down with the patients to take the time to listen to them and answer any questions they have.”

HealthSpring Executive Vice President Shawn Morris said the 360 Physical is part of the Medicare plan’s drive to focus on prevention and early intervention. “We know it’s better for everyone if our members get regular preventive care and exams to catch problems early,” he said. “Our primary goal is to help our members stay as healthy as possible. The 360 Physical is designed to make it easy for members who have certain health risks to receive quality preventive care. We then combine that with a strong emphasis on helping members build relationships with their primary care providers.”

HealthSpring began the 360 Physical as a pilot program in its Texas market in late 2008, HealthSpring Chief Medical Officer Dirk Wales said. It has been exceptionally well-received by members and has now been rolled out to all HealthSpring markets. About 16,000 total home visits have been conducted so far through the program, Wales said.

HealthSpring members with certain high-risk medical conditions or who have not seen a primary care provider in the past six months to a year qualify for the 360 Physical. The visiting nurse takes a detailed medical history and conducts a thorough head-to-toe physical exam, including a key exam to check circulation in the feet for diabetic members.

“Mr. Lusk’s story is encouraging, because it tells us we really are making a difference by proactively sending care out to members,” Dirk Wales said. “This is why we do what we do: to protect our members’ health so they can live long, full lives.”