The U.S. Medicaid program is a joint federal and state program that helps low-income individuals or families pay for the costs associated with medical care.
Nationwide there are more than 50 million Medicaid beneficiaries, about 15% of which are children enrolled in the Children’s Health Insurance Program (CHIP).
Medicaid beneficiaries struggle with poverty and many face physical and/or mental illness.
A 24-hour Nurse Advice Line is a critical support service that provides easy access to help and information. Here are just five of the many ways that 24-hour Nurse support is a critical resource for Medicaid beneficiaries.
According to recent BBC research, a child dies in the United States every 5 hours as a result of abuse or neglect. America has the worst child abuse record in the industrialized world. Many hypothesize that poor, young, uneducated parents are more likely than other parents to mistreat their kids.
Mothers and fathers who lack financial resources and education need extra support as they navigate the challenges of parenting. 24-hour access to a Nurse is a critical lifeline when a child is ill or a baby is crying. The 24x7 Nurse Advice Line does not have the negative stigma associated with it that might prevent a parent from calling a child abuse prevention line.
The calm, re-assuring voice diffuses dangerous tension and gives the parent an outlet to express their concerns. Gallup polls have found that Nurses are the most trusted of all healthcare workers. The Advice Nurse is trained to provide reassuring support for the parent. The Nurse has resources to provide clear health advice and help the parent to find the support that they need within the local community.
The U.S. Department of Health and Human Services defines health literacy as, “The degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.” According to the American Medical Association, poor health literacy is "a stronger predictor of a person's health than age, income, employment status, education level, and race". The most vulnerable populations include the elderly, minority populations, low-income populations and people with chronic mental and/or physical health conditions.
24-hour access to a Nurse allows Medicaid beneficiaries to ask questions about medications, procedures, screenings, health conditions or any other health related topics. The service provides tremendous value for members who are struggling with the complexity of healthcare and need an impartial sounding board to answer questions in plain language. Nurses access consumer friendly health information, including decision making and self-care tools, which are shared with the caller by phone and can also be mailed or e-mailed.
Mental Health Support
Medicaid is the single largest payer for mental health services in the United States, providing services and support for 58 million adults and children. The 24x7 Nurse Advice line can be a vital first line resource for members with mental health concerns including anxiety, depression, and suicidal thoughts. The Nurse is trained to assess the members' concerns with empathy and compassion. Physician authored clinical protocols are used to determine if emergency services are needed, and referrals are made to local agencies and support services as appropriate.
Medicaid members often struggle to find a way to get to medical appointments, especially in rural areas where public transportation is not an option. Members may hesitate to have health concerns evaluated due to a lack of transportation. The 24-Hour Nurse Advice Line uses physician authored clinical protocols to determine if a medical appointment is necessary. The member benefits from a single point of contact that can determine the most appropriate level of care and then ensures that the “loop is closed” by securing the appointment, and the ride, for the member.
A Link to Community Resources
At the end of the day, all healthcare is local. But members may not be aware of all the local resources that are available to them, including health clinics, educational programs, and other resources within the community. The 24-Hour Nurse Advice line is a referral hub for these kinds of programs and more. The Advice Nurse uses the information shared by the member to locate and share appropriate resources. The Nurse connects the member directly with the resource when possible or provides a message to the program or facility indicating that the member would benefit from outreach.
Key Takeaway: These are just some of the many ways that a 24-Hour Nurse Advice program serves as a critical lifeline. As the number of people who qualify for Medicaid continues to grow within the U.S., it will be essential for states and managed care plans to include this kind of service in their program design as a vital connection point for members.