Telephonic outreach by healthcare case managers helps to bridge the care divide, supporting and improving the health of vulnerable and high-risk populations, says Jay Hale, LPC, CEAP, director of quality improvement and clinical operations at Carolina Behavioral Health Alliance (CBHA). Matching members with the right case manager based on utilization review (UR) information — some members are more comfortable with men than women is one of the keys to engaging and maintaining telephonic relationships.
Once we get in contact with someone, we are going to describe this service in terms of how it can help him or her. “This is a service that helps you see how well you are doing.” Other phrases we use include, “We are here to support you in your recovery,” or “We are here to help you and your son/daughter.” We use very positive things, and we let them know that there is no cost to them for the program. We are not trying to sell them something, and that is certainly a positive. This is part of their health plan, and we provide this service to help them see how well they are doing. That phrase works for them because it has a very positive tone to it.
We also want to match case managers to the members as much as possible. As we manage care, we can see that individuals are more comfortable with a male or a female based on our UR information. They may be more comfortable with someone based on their issues, so we want to try to have the appropriate person do an outreach call to them. Because of that, we may learn about varying times of day to call.
We also found it is important for the case managers to know the therapeutic language that the member has learned. Specifically in substance abuse, we want people who are familiar with that language so that they can talk about supporting recovery, working a program, avoiding old playmates and playgrounds, working the steps, the big book and sponsors. There are certain words that are very specific to that language and to that program. If we can use that language comfortably, then that increases member engagement.
For mental health adult patients, it is usually talking in terms of symptoms, homework, self-care activities and things like that. They are more comfortable with medically based issues and concerns. With child/adolescent patients, it is important to talk in terms of supporting their sons/daughters in engaging in successful behaviors. These behaviors include actions that are going to improve them, help them be better or help them improve their school or home. We want to take the negativity out of that process.
While we have a specific survey that our case managers are supposed to use, we found that it is better to do that in a conversational style, rather than a specific “read a question, wait for an answer” style. This helps keep members engaged in the process because it feels like a conversation rather than a survey. Being conversational with individuals keeps them involved and engaged in the process.
Telephonic Case Management Protocols to Engage Vulnerable Populations examines the case management protocol developed by Carolina Behavioral Health Alliance, including the use of scripts and surveys to assess patients’ engagement in the treatment process and to identify patients at-risk.