Eight Questions to Ask When Evaluating Nurse Line Vendors

A nurse line can be a valuable resource for your members, helping them assess their symptoms, understand their condition, treatment and care options, and how to handle a potential emergency. But how do you select a vendor that will provide a positive experience for your members and deliver quality clinical outcomes?

Health Dialog’s more than 20 years of experience in developing and implementing nurse line services has taught us what it takes to deliver a successful nurse advice line. Here are eight key questions to ask when evaluating nurse line vendors:

1. Who specifically answers calls to the nurse line and what are their qualifications?

Members want immediate service, especially regarding health concerns that could lead to decisions for themselves or other family members about whether to call 911 or visit the emergency department (ED).* Health Dialog’s Nurse Advice Line is staffed with experienced registered nurses, licensed to practice in all 50 states, the District of Columbia and Guam, who answer calls directly. We do not route calls through a “transfer” or “call-back” system.

 

2. What types of calls do you handle? How is each call supported from a clinical perspective?

Urgent calls might include evaluating symptoms of a heart attack or stroke and non-urgent calls might include questions about anything from insect bites to local health services, such as transportation or community resources. Health Dialog uses a systematic and proven approach to assess symptoms and provides timely information to help make urgent, acute or general health decisions.

 

3. Is your nurse line NCQA certified and URAC accredited?

Health Dialog’s Nurse Advice Line is one of only six to earn the National Committee for Quality Assurance’s (NCQA’s) Health Information Products (HIP) Certification for a Health Information Line and is accredited by URAC for Health Call Centers. These organizations provide an independent, third-party evaluation process to ensure high-quality health service programs.

 

4. Can you help members navigate the healthcare system, and can your services integrate with other plan-sponsored resources?

Ensuring appropriate use of care and directing people away from the ED when it is not clinically appropriate are important elements of a nurse line program; however, there are other ways a nurse line can help meet your population health management goals. If your health plan provides local services, like transportation, fitness classes or support groups, make sure your nurse line vendor has processes in place to help connect your members to these services. Health Dialog Health Coaches refer members to plan- and provider-sponsored resources.

 

5. How do you handle Spanish-speaking and other populations whose first language is not English?

Depending on the demographics of your member population, your nurse line vendor may well need nurses
who can speak fluent Spanish. Health Dialog offers nurses bilingual in English and Spanish, as well as translation services in over 200 languages available in real time.

 

6. How will you report on utilization of our nurse line?

The primary goal of any nurse line is to ensure the appropriate use of healthcare resources to improve clinical outcomes. Health Dialog’s reporting package provides robust detail about your population, including operational metrics, program activity, member satisfaction and details on the appropriate redirection of care.

 

7. Can you show actual results that demonstrate the success of the nurse line services?

As mentioned above, Health Dialog provides robust reporting on our program’s success. Our experience shows
that, on average, 73% of members with a pre-intention of visiting the ED or calling 911 can be redirected when a
lower level of care is deemed appropriate. These cost savings add up. A visit to the ED costs approximately
$1,389 per patient, 12 times more than a physician’s office visit and 10 times more than an urgent care center. [1], [2]
Many ED visits are unnecessary but happen anyway because members aren’t always sure what constitutes an emergency or what alternative resources are available.

 

8. How will members learn about the new nurse line services?

Program awareness should be established through tailored communication and engagement. Campaigns must be crafted to a population based on demographics, clinical needs, cultural differences, language fluency, past behaviors, geographic factors and more. Health Dialog’s campaign pieces include general awareness letters or emails, seasonal reminder postcards or emails, and provider office flyers and posters.

By asking prospective vendors these eight questions, you can ensure you're getting the results you want while helping your members achieve whole health for life.

 

* If you are experiencing a medical emergency, please contact 911.

[1] Alltucker, K (2019). ‘Really astonishing’: Average cost of hospital ER visit surges 176% in a decade, report says. USA Today. June 4, 2019.
[2] Lagasse, J (2019). Diverting avoidable emergency department visits could save healthcare $32 billion annually. Healthcare Finance.

Topics: Solutions & Best Practices, Nurse Advice Line

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