While health plan members participating in high deductible health plans may become more attuned to the costs associated with their healthcare choices, there are occasions when they should use services for acute, non-critical conditions but don’t because of the high-deductible barrier. In these instances, it makes sense to provide a free healthcare service for acute conditions that members would otherwise avoid because of cost. In this article for The Institute of HealthCare Consumerism, Naoise Colgan, vice president of Care Management Solutions, McKesson Health Solutions, explores how a targeted nurse advice program can benefit the member and the plan.

Provide More Care, Improve Quality Without Breaking the Bank

The reasons payers choose to implement nurse advice services are quite different. Directing members, however, to timely, appropriate care is one that’s undergoing something of a renaissance in the health care world. We see this happening because nurse advice can help improve the quality of care for members and has the added benefit of lowering costs for the health plan and, importantly, may qualify as a quality improvement activity under the medical loss ratio. In this article, Naoise Colgan, vice president of Care Management Solutions, McKesson Health Solutions, investigates how commercial health plans can put this service to use.

Nurse Advice Value

Care management ROI has been hotly contested since the first program began. There are many issues that cloud ROI and its accuracy. Naoise Colgan, vice president of Care Management Solutions, McKesson Health Solutions, explores a new way to look at ROI and care management programs as whole, including program transparency, the vendor/payer partnership and clinical outcomes.

Value of Care Management

States are faced with helping 6 million new Medicaid beneficiaries who joined the government health program during the economic downturn. As unemployment rises, so, too, do the number of people using Medicaid as the long-term unemployed give up employer-sponsored health benefits. States want more value and efficiency from their health care programs, and they continue to look to commercial payers for support and answers, especially when it comes to managing the long-term, chronic illnesses of these Medicaid beneficiaries. In this article, Naoise Colgan, vice president of Care Management Solutions, McKesson Health Solutions, discusses how commercial payers with Medicaid managed care programs can meet the needs of this complex population.

Medicaid Managed Care and Care Management