Health insurance case study: one-nurse-one-patient support for Saudi expat in the US

7,000 miles from home, a man with a debilitating disease navigates a complex health care system with the help of his dedicated nurse

The patient

Meet Bassel*, a 59-year-old man from Saudi Arabia who lives, with his wife and son, and works in the U.S.. Bassel has been an Aetna International member since 2013 and has an International Private Medical Insurance (iPMI) plan with health and wellness benefits.

MS in the US article graphic detailing a journey from Saudi Arabia to the US MS in the US article graphic detailing a journey from Saudi Arabia to the US

Telling Bassel’s story is the best way to explain how our global experience, local expertise and human touch leads to the best health outcomes for our members and their employers.

2013: The illness

In 2013, Bassel starts to show some of the symptoms of multiple sclerosis (MS) — a condition in which the body’s immune system begins to attack the central nervous system. The symptoms can include fatigue and weakness; vision, mobility and cognitive problems; and pain. Later that year, he is diagnosed with MS, joining the  2.3 million people worldwide already affected by the condition.

MS in the US article graphic detailing the symptoms of multiple sclerosis MS in the US article graphic detailing the symptoms of multiple sclerosis

As well as the challenges caused by his emerging symptoms, Bassel also has to navigate the complexities of a health care system in a foreign country. It’s overwhelming, but he doesn’t have much choice.

Bassel’s plan includes access to Aetna’s Care and Response Excellence (CARE)  team, which offers members services such as the In Touch Care (ITC) clinical programme. ITC helps members manage their conditions and ensures that they’re receiving the right treatment and support to help them achieve the best health possible. As part of this, Aetna International assign a registered nurse to look after Bassel while managing his case.

The nurse

Meet Souha, part of the CARE team who support members on a one-to-one basis. Souha has 10 years of intensive care, paediatric and neo-natal experience — four with Aetna International. An experienced nurse, she speaks Arabic, English and French. On becoming Bassel’s personal nurse and key point of contact, the two begin a journey together. With so much unknown and uncertain, it is comforting for Bassel to know that, through the ITC programme, Souha is there.

MS in the US article graphic detailing Aetna International's In Touch Care programme MS in the US article graphic detailing Aetna International's In Touch Care programme

“When I first speak with my patients, they’re often scared and unsure about how to proceed,” says Souha. “It means a lot to me to be able to help them through what can be one of the most difficult times in their lives and that goes for the families as well.”

First, Bassel needs medication to manage his symptoms and help prevent his condition from worsening. Souha receives the request and reviews his case and answers all of his questions about his diagnosis, medication and treatment. “It’s like having my own personal nurse to answer all my questions,” Bassel tells us. “She helps me make the important decisions about my health care.”

The CARE team always work with their patient to understand his or her needs. Souha and Bassel build a picture of his unique situation to make the best decisions about his health care and he begins to manage his condition.

Each year, Souha reviews Bassel’s situation and preauthorises his medication for the year.

2016: An acute episode

At the end of 2016, Bassel suffers an acute episode with excruciating pain in his back and right leg. After trying to walk with a cane he realises he needs a wheelchair, becoming reliant on his wife and son to get around, manage everyday tasks and manage his pain. 

MS in the US article graphic detailing the stages of multiple sclerosis MS in the US article graphic detailing the stages of multiple sclerosis

Bassel contacts his trusted one-to-one nurse to ask for guidance and support as his condition clearly needs further investigation. Over the years, Souha has become familiar with Bassel’s situation, from his health history to his life and circumstances. She recommends an appointment with a primary care doctor, who refers him for an MRI scan. Souha preauthorises the MRI and stays in touch with Bassel and his family via phone calls and text messages, giving them direct, quick and convenient access to the information and support they need at this difficult time.

2016: The diagnosis

The MRI reveals a herniated disk in Bassel’s lumbar region and the doctor recommends a consultation with a specialist surgeon. Souha preauthorises the appointment and connects with the specialist who recommends surgery. Souha reviews the case and, after discussion with Bassel and his wife, preauthorises his surgery.

Souha begins to coordinate Bassel’s post-surgery care and rehabilitation with the specialist and hospital to make sure everything runs smoothly for Bassel and his family.

2017: Surgery

In January, the big day arrives and Bassel undergoes surgery on his back. With a lot at stake, everyone is overjoyed that the procedure is executed successfully. “It was a tense time, but Bassel, his family and the surgeons were all fantastic,” remembers Souha.

MS in the US article post-surgery graphic MS in the US article post-surgery graphic

Not all patients require specialist care post-surgery, but in Bassel’s case he is quickly transferred to a prearranged rehabilitation care for 14 days. All this time, Souha liaises with the hospital regarding his progress, keeping his family up to date.

After 14 days of rehabilitation and with the aid of a walker, Bassel begins to walk again.

2017: Ongoing support

The big job is over, but as the months pass, Bassel again needs the advice and guidance of someone he can trust so he calls his friend in the CARE team, Souha. He asks her to recommend a local primary care physician for specialised support. Souha gets to work and finds a quality doctor in Bassel’s local area who is part of Aetna International’s network of leading providers and specialists.

As part of the growing relationship, Souha also helps Bassel with medication refills — connecting directly with his local pharmacy to organise.

2017: Back to work

In March 2017, less than three months after back surgery, Bassel no longer needs to use a cane and he returns to work. He is relieved, and he is not alone.

“We [in the CARE team] often build nurse-patient relationships over long periods of time and through difficult stages in people’s lives, it’s not surprising that we really care about their well-being. That’s why it feels good to be part of a success story like Bassel’s — being a central point between him, his family, clinicians and providers to ensure he gets the best outcome.”

2018 and on

The pair continue to speak, and Bassel is managing his MS. He is as healthy as he can be as he continues to enjoy his life as an employee, a friend, a father and a husband.

How to benefit from In Touch Care

The personal attention Bassel receives to help him manage his condition is not unique, it’s the norm. All members who opt to receive support via the CARE team’s In Touch Care programme receive this level of personal care because we believe in being there for our members whenever and wherever we’re needed.

Employers like the In Touch Care programme because it supports their duty of care to employees as well as helps keep their teams happy, healthy and productive. Aetna International’s members benefit from having the support of their own personal nurse. Both benefit from the ‘one clinician to one member’ approach, which means we’re able to more effectively assess member needs and wants, and better support them on the road to better health.

Dedicated clinicians:

  • Get to know an individual personally including their health history
  • Develop a customised action plan
  • Help members make lifestyle related changes to help get well or manage conditions
  • Help individuals navigate care, prepare for a hospital stay or plan for recovery
  • Serve as an advocate in the case of challenges.

The CARE team’s In Touch Care programme includes:

  • One-on-one phone calls with a trusted family nurse
  • Expert guidance to help make the best decisions about treatment and car
  • A customised health plan based on personal needs and preferences
  • Being a part of a connected care system, where we connect with you, your family, your doctor, specialists and support services to work towards the best health outcomes.

Through the In Touch Care programme, we not only support businesses and their employees today, we also prepare people for tomorrow through our proactive approach to care management.

Built into our benefits plan, the CARE team offers Aetna International employers confidential, comprehensive resources. This support can also help make a huge difference for employers in managing workforce health and productivity. With the help of our improved member detection analytics, we can identify those who need help the most. The result is a seamless health care experience with the best possible outcomes for members and a healthier bottom line for our customers.

Request ITC support via the CARE team 

To contact the CARE team to request ITC support, members should login to the Health Hub — your online member account. Don't have an account? Register in two minutes. 

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The CARE team can also support Aetna members with global pre-trip planning, coordination of care, help finding specialist providers and medical emergency assistance.

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