Nurse Triage Callers More Likely to Join, Remain in Disease Management Programs: Disease Management Journal

Published in the October 2007 issue of Disease Management, the peer-reviewed journal of the Disease Management Association of America, titled, “Opening the Door to Coordination of Care Through Teachable Moments,” focuses on the window of time when a person who calls a triage line for advice about an acute medical issue may also be open to receiving DM services.

Researchers learned that triage callers are not the “worried well” – those essentially calling a nurse for reassurance – but rather “self-identified members who appear to be sicker than the average health plan member,” according to the research.

Researchers also found other significant differences between the groups:

• Participants who were referred to DM programs through nurse triage used the services and stayed enrolled at higher rates than those who entered a DM program using traditional outreach.
  • In the diabetes program, 77 percent of referred members enrolled in the program; and 57 percent of referred members enrolled in the asthma program.
  • For both groups, these percentages are higher than for members who entered the programs through traditional outbound calls and outbound mailings, 35 percent and 27 percent for diabetes and asthma, respectively.
• Health plan members who entered a DM program through the nurse triage service were also more likely to remain in the program compared to their counterparts who entered through traditional outreach.
  • Forty-one percent of members who entered the asthma program through nurse triage participated for 12 months, compared to 20 percent participation for 12 months in the standard outreach program.
  • For those who entered the diabetes program through the nurse triage service, 61 percent participated for 12 months compared to 29 percent.

The study demonstrates that DM programs have another effective strategy available to aid in the enrollment and retention of participants. Traditional approaches to enrolling members in DM programs can be complemented by triage services. Combining these approaches can optimize enrollment and overall participation rates.

This program was conducted among federal employees who reside in Texas and who are enrolled in Blue Cross Blue Shield coverage.

Authors of the article are: Gregory D. Berg, Ph.D., McKesson Health Solutions; and Allan M. Korn, M.D., Eileen Thomas, R.N., CCM. (retired), Linda Klemka-Walden, Marysanta D. Bigony, RN, MSN, APRN, BC, CCM and John F. Newman, Ph.D., CHE all of the Blue Cross and Blue Shield Association.

About McKesson Corporation

McKesson Corporation, currently ranked 18th on the FORTUNE 500, is a healthcare services and information technology company dedicated to helping its customers deliver high-quality healthcare by reducing costs, streamlining processes, and improving the quality and safety of patient care. McKesson is the longest-operating company in healthcare today, and will mark 175 years of continuous operations in 2008. Over the course of its history, McKesson has grown by providing pharmaceutical and medical-surgical supply management across the spectrum of care; healthcare information technology for hospitals, physicians, homecare and payors; hospital and retail pharmacy automation; and services for manufacturers and payors designed to improve outcomes for patients. For more information, visit www.mckesson.com.

About Blue Cross and Blue Shield Association

Blue Cross and Blue Shield Association is a national federation of 39 independent, community-based and locally operated Blue Cross and Blue Shield companies that collectively provide healthcare coverage for more than 98 million – nearly one-in-three – Americans. For more information on the Blue Cross and Blue Shield Association and its member companies, please visit www.BCBS.com.

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