Connecting Members to Benefits and Services that Improve Care

Telephonic nurse lines are effective in delivering clinical information to people who call in and ensuring appropriate use of care. In fact, according to Health Dialog’s data, up to 75% of our members who called our Nurse Advice Line with the intent of going to the emergency room (ER) or calling 911 were re-directed to a less emergent level of care. However, nurse lines are more than just clinical call centers that help people evaluate their symptoms. For those who struggle to navigate a complicated healthcare system, nurse lines can help bridge the gap.

Specifically, nurse lines can also help members:

  • Access Plan-Sponsored Benefits and Resources – Some members might not be aware of the benefits their plan offers that can help them better manage their health, such as case management, disease management, telehealth, mental health, wellness programs, second opinion services, online portals, mail order pharmacies, transportation and more. When a member call a nurse line, they can be connected to these valuable resources.
  • Identify Community Resources – When a member calls a nurse line, they can be provided with information on available healthcare and wellness resources right in their community, such as community centers, apps, online tools and other resources. For instance, some plans offer complimentary fitness classes at local YMCAs and use their nurse line to help spread the word to members when appropriate.
  • Eliminate Knowledge Gaps – Nurse lines can help members who call in eliminate knowledge gaps associated with chronic or acute conditions, which can also help members plan for, or avoid, hospitalizations and disease progression.
  • Prepare for Doctors Visits – Nurse lines can work with members who call in to develop a more focused or comprehensive list of questions the member should be asking their providers for more efficient office visits.
  • Improve Medication Adherence – Studies have found that 50% of people with chronic conditions do not take their medications as prescribed, which can lead to costly health complications.[1] Nurse lines can improve medication-taking skills, help member’s better understand therapeutic guidelines and drug interactions, and identify plan-approved resources or programs that can help eliminate barriers to adherence, improving health outcomes.
  • Promote Health Services – Nurse lines can promote services, programs and vaccinations to members who call in, which can reduce gaps in care or improve quality measures. For instance, some health plans use nurse lines to remind members of yearly flu vaccinations.
  • Schedule Appointments – Nurse lines can even help callers schedule necessary services, ensuring access to care.

Providing a nurse line for your members can ensure they have access to the benefits, resources and information they need to effectively manage their health, improving outcomes and controlling costs.

 

[1] Brown, M.T., Bussell, J.K. (2011). Medication Adherence: WHO Cares? Mayo Clinic Proceedings.

Topics: Solutions & Best Practices

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