The Role of Telephone Triage Nurses in Delivering Value-Based Care

As the healthcare industry continues to undergo transformative change and emphasize improved quality with a lower total cost of care, health systems are making the shift from volume to value. The notion of paying for performance is the industry’s most promising strategy for controlling costs and improving outcomes. There is growing evidence that value-based care leads to better health, better care, and reduced total cost.

Value-based care necessitates a network of engaged, aligned physicians who can focus not just on the patient in front of them but on improving the health of the patient population.

While most health systems are still operating in a primarily fee-for-service environment, value-based care is nudging the half-way mark as more and more payers, and providers shift their contracts away from fee-for-service arrangements, according to the Health Care Transformation Task Force (HCTTF).

Payers and providers are leveraging this trend by appealing to the access and convenience desires of targeted patient groups, focusing on high-cost, high-risk patients and meeting value targets by managing their care. This technique works well in Medicare and is rolling it out in Medicaid. On the flip side, quality outcomes and cultural/behavioral changes are more important in the commercial market since there are fewer high-cost, high-risk patients.

However, the transition to value is a challenging journey, and much work lies ahead. As a result, organizations face challenges around maintaining care delivery uniformity across the health system. Successful value-based care requires that health systems have many new capabilities and structural elements in place.

Additionally, the effort entails addressing variations in care, sometimes among independent physicians, and between different hospitals and other facilities throughout the system. This means they must offer the range of providers and care sites needed to provide patients with access to the right care in the right setting at the right time and the right cost, while also ensuring the patient population is aware of its offerings to prevent patients from seeking care elsewhere.

More than ever, it is becoming crucial to have 24/7 access to a triage nurse to ensure that patients can connect from anywhere, preventing patient leakage and provides appropriate levels of care.

One way to do this is by employing an outsourced telephone triage call center to help with the care transition process. A nurse call center system armed with good data analytics allows you to identify the quality of the clinical call center and improve the efficiency of the nursing staff while helping patients at the same time.

Organizations like TriageLogic provide outsourced telephone triage services to increase access and utilization for patients, ensuring care transitions are smooth and patients receive appropriate care.

Implementing tools like the MyTriageChecklist® ensures the process for evaluating and documenting patient calls is appropriate. Tools like the My 24/7 Healthcare™ mobile app also give patients easy access to your office information and a direct way for providers to communicate with their patients, regardless of location.  Having access to this data, analyzing it, and sharing the information with providers improves patient care, while at the same time showing the value of your call center service and saving valuable health care dollars.

For more information about the value triage nurses provide to patients suffering from mental health issues, contact TriageLogic.

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