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Accountable Care Organizations Can Decrease Unnecessary Patient Expenses with Nurse Triage

Accountable Care Organizations Can Decrease Unnecessary Patient Expenses with Nurse Triage 

Accountable Care Organizations (ACOs) are designed to encourage high-quality and less expensive treatments for patients. As a provider, you receive a reward if your patients stay out of expensive care and expensive hospitals. Similar incentives for providers are emerging from insurance companies as well. There are many strategies your practice can implement to reach the established ACO goals. This article discusses one necessary and easy way to implement a solution. A nurse triage service can help to ensure that your ACO is meeting regulation guidelines and helping patients stay out of expensive care.

Telehealth and nurse triage services, like TriageLogic’s Nurse Triage On Call, allow ACOs to keep patients out of emergency rooms and hospitals whenever possible, and help patients manage their own care through compliance with medications and needed appointments. Having the option for patients to call their provider, rather than make a physical office visit, has significant savings in time and money for both the provider and patient. Triage nurses take patient phone calls using standardized guidelines (see Schmitt-Thompson Protocols), and custom orders by each physician. Nurses also send the encounter details to the doctor’s office for ease of follow up.

Jim Hodge

When speaking of how a nurse triage system has helped his ACO, Jim Hodge, former CFO at Cornerstone Health Care, said that “TriageLogic provides better patient access, allowing us to have nurses on call at night, so that patients can call without having to go to an emergency room for care.” He continues, “We are pleased with TriageLogic’s system because it provides access to our patients and allows us to do this at a reduced cost, allowing an improved quality of care to our patients.”

How do ACOs Impact Patients?

ACOs need to ensure that patients have access to the right level of care, at the right time. Research has shown that patients with healthcare problems, especially during the night, often consider going to an emergency room. However, with the help and advice of a trained nurse on the phone, there are often home care options. Telephone nurse triage, such as that provided by TriageLogic, offers patients access to trained nurses who use established, gold-standard medical protocols to help patients determine when they need emergency care and when they can safely wait to see their own physician.

Studies, including TriageLogic’s call center data, show that over half of patients who thought that they needed to seek emergency care were actually recommended a less expensive option or home care after being triaged by a nurse. More alarmingly, almost 10% of the patients who thought that their symptoms were not serious enough to seek immediate care ended up receiving instructions to go to the ER, and in a few cases call 911. Getting emergency care when necessary can have huge implications on improved overall patient health and decreased future complications and expenses.


Meeting Objectives

Using nurse triage as a tool, ACOs are able to prevent unnecessary and expensive medical care for program beneficiaries by having nurses evaluate and assess symptoms of the phone. ACOs have the potential to significantly improve patient outcomes and decrease healthcare costs. It is imperative that the ACOs that are effective be rewarded appropriately and receive more resources so that they can continue improving healthcare.

To hear more about how our nurse triage service has helped Cornerstone Health Care, watch this short video.