In BlueCross BlueShield of Tennessee's experience, nurses are the key to disease prevention and management efforts that help improve patients' quality of life, BCBST Chief Medical Officer Andrea D. Willis, M.D., writes in an opinion piece for the Tennesseean.
Nurses who work for the insurer most often connect with members managing a chronic health condition, including the five of the most common among Tennesseans: Congestive heart failure, diabetes, asthma, chronic obstructive pulmonary disease and coronary artery disease, Willis writes. Connecting patients with nurse care managers, she says, helps them be more compliant with their doctors' orders, and they are therefore less likely to visit the emergency department or be admitted to the hospital.
If BCBST members are admitted to the hospital, the insurer's nurses work with them upon admission and continue working with them after discharge, Willis adds. This is to make sure they understand their medicines and follow-up needs, which shortens recovery time and helps manage costs.
In addition to working with those who have chronic conditions, BCBST's clinical teams call members to encourage them to get critical preventive procedures such as mammograms or colon cancer screenings, Willis says. Nurses, she says, also help shape medical policy and participate in product development and wellness consulting teams.
Humana, Cigna and UnitedHealth have all turned to the expertise of nurses to power care coordination. Overall, demand for nurses continues to grow, leading many hospitals to create nurse residency programs to boost experience and skill sets.
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