Managed Care - August 2012 - (Page 44)

P L A N W AT C H Silvaggi says that the motivational interviewing program, launched in February 2011, is vital because it is a new approach to the patient/ provider dynamic. The more-than-200 participating nurses were, at first, “a little apprehensive because they thought everybody would just hang up on them.” Cross Blue Shield of Michigan nurses have been taught that the secret word that lessens that possibility is “free.” Everything being offered is part of the benefit package, so it’s not free, but there’s no extra cost either. “The nurses have been taught how to have that conversation and to do the baby steps so that it’s not overwhelming for the members,” says Silvaggi. “But at the same time, it’s an Aha! moment for the members. They’re actually participating in their own care and learning how to manage their conditions.” The nurse/patient interaction is altered from the beginning. The nurse in effect is saying, I’m here to do this with you. “How do I partner with you?” says Silvaggi “The other piece that we find really helps is when we ask the members, Do you have time to talk? It kind of opens up that dialogue where it’s giving them that control to say, I can’t talk right now but I’m interested in this. Then the nurses would come in and say, OK, what time works best for you?” The nurses are continually being monitored and trained. HealthSciences listens at least once a month to nurse calls, and provides tips on how they could be handled better. “We say, You did a really great job using the motivational interviewing skills. But what are some other techniques that could have been used?” New philosophy “Years ago when we were in nursing school, we were taught to tell the patient, You need to do this, you need to do that. Motivational interviewing takes on a different philosophy that promotes engaging the patients, helping them be a part of their own care, helping them identify barriers to making improvements. We ask, How do you think you can move forward with these barriers that are in place?” For example, a barrier could be that the patient is not near a fitness center to work out. The nurses would talk to the patient about how he can exercise at home. One important skill that nurses who have gone through the training have learned is how to put the patient at the other end of the phone at ease. Most people are inclined to hang up if they aren’t familiar with the caller, but Blue “Legal says ‘Just do it, and don’t get caught.’” Open-ended One of the main techniques is the use of open-ended questions that may lead the patient to give more information than could be obtained by having the nurses probe and pull for everything. “We get a report quarterly that shows us how successful our nurses are in using openended questions like What do you think would help you manage your asthma? rather than in going through a checklist of what triggers asthma attacks,” she says. In this way, the insurer hopes to create a population of engaged consumers, which is what health care seems more and more to be about these days. 44 MANAGED CARE / AUGUST 2012

Table of Contents for the Digital Edition of Managed Care - August 2012

Managed Care - August 2012
Editor’s Memo
Contents
Legislation & Regulation
News & Commentary
Medication Management
Evidence Review
Compensation Monitor
Private Exchanges: Practice Makes Perfect
Hospitals and Providers Ganging Up on Plans?
Q&A: Kaiser Permanente’s Sharon Levine, MD
God Save the Health Care System!
Future Points to Greater PBM/Plan Cooperation
Formulary Files
Plan Watch
Tomorrow’s Medicine
Outlook

Managed Care - August 2012