Dajia Richardson is driving through a snowy upstate New York neighborhood to the home of an Excellus BlueCross BlueShield (Excellus) member. The member has high blood pressure, and he hasn’t been answering calls from a nurse case manager who can help him manage his condition. When Richardson arrives, the member’s car isn’t in the driveway, but she knocks on his door anyway. Inside, after explaining why the Excellus nurse has been calling, his reluctance to participate vanishes. Richardson enrolls him in the case management program for members with high blood pressure. A nurse can now help him stay on track with medications and healthy behaviors.
For Medicaid beneficiaries, Richardson’s role is critical. These members can be among a health insurer’s most vulnerable. They face high rates of poverty, lack transportation to get to medical appointments, struggle to afford healthy food and find secure housing, all of which interfere with a member’s ability to stay healthy. Some lose touch with the healthcare system because they’re trying to meet basic needs.
Safety net team reconnects members to care
That’s why Excellus BCBS has deployed this Safety Net CARE team in upstate New York (CARE stands for Committed and Accountable to Relentless Engagement). As part of an approach to care that’s focused on the member, employees drive the streets, knock on members’ doors and even search homeless camps. They meet members where they are, whether they’re out of work, needing housing or facing other barriers. And when they track a member down, they’re equipped to help break down those barriers to better health.
“It goes to the heart of our mission as a nonprofit health plan to ensure as many people as possible have access to quality healthcare at an affordable price,” said Barry Thornton, Executive Vice President of Operational Excellence at Excellus BCBS.
Excellus BlueCross BlueShield is an independent licensee of the Blue Cross Blue Shield Association, an association of independent, locally operated Blue Cross and Blue Shield companies.