Article
Tales From the Call Center: The American Journal of Accountable Care® Studies a Payer's Community Lifeline
“Care coordination” is a healthcare buzzword, and nurses provide much of the clinical support. Until now, few studies have examined the laypersons who set up rides, connect patients with government benefits, and just listen.
Healthcare has long recognized that for patients facing a constellation of chronic conditions, poverty, and social ills, the events that crop up between visits do more to derail health than anything that happens in the physician’s office.
Terms like “care coordination” and “navigator” have sprung up, reflecting the work of personnel who meet these needs. But how much do we know about the nonclinical staff who fill these critical roles?
In the current issue of The American Journal of Accountable Care®, authors Zachary Pruitt, PhD, Pamme Lyons Taylor, MBA, MHCA, and Kristopher M. Bryant, BS, examined staff who held the title of “CommUnity Liaison” for WellCare, setting up services, finding financial and housing assistance, and often providing emotional support that was beyond their job description.
The article contains qualitative accounts from liaisons, many of whom embrace their role in the healthcare chain. One said:
In the beginning of the call, they sound very disheartened … and embarrassed for asking for assistance. And then by the end of the call, typically their attitude changes, their tone of voice changes. And it’s just providing the information for them to be able to help themselves. It’s tremendous! I think that’s better than just giving assistance.
The study found (1) some staff had a physical disability or healthcare experience that helped them relate to the clients who call for assistance, (2) while many provided emotional support, this was not consistent, (3) some reported that stabilizing the client emotionally was a prerequisite to successfully addressing financial or support needs, (4) CommUnity Liaisons acted as connectors rather than providers of direct aid.
“We learned that CommUnity Liaisons perform a unique function in the social and medical care integration effort,” the authors said. “People contact the call center because of some social crisis in their life, not necessarily because of any medical need. We found that the call center representatives provide social support in stressful circumstances that may not warrant the services of a doctor, nurse, or medical social worker. Since healthcare providers may lack the time or inclination to address the social determinants of health, this role may be a valuable addition to the evolving healthcare workforce.”
About The American Journal of Managed Care®:
The American Journal of Managed Care® (AJMC®) is a peer-reviewed, MEDLINE-indexed journal that keeps readers on the forefront of health policy by publishing research relevant to industry decision makers as they work to promote the efficient delivery of high-quality care. AJMC.com is the essential website for managed care professionals, distributing industry updates daily to leading stakeholders. Other titles in the AJMC® family include The American Journal of Accountable Care®, and two evidence-based series, Evidence-Based Oncology™ and Evidence-Based Diabetes Management™. These comprehensive offerings bring together stakeholder views from payers, providers, policymakers and other industry leaders in managed care. To order reprints of articles appearing in AJMC® publications, please contact Jeff Prescott at 609-716-7777, ext. 331.
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