Service addresses a wide range of member concerns

Counselors provide assessment, plan of care

No matter which Lifepath Adviserssm service Blue Shield of California members choose, they get a comprehensive assessment and a plan of care to help them deal with their problems.

"We designed the program as an integrative service that can address the broad range of concerns people told us affects their health. We combined them with our health plan benefit and our mental health benefit and use the same network of pro-viders to deliver the services," says Deborah Schwab, MS, RN, director of new product development for the San Francisco-based health plan.

Here are the three components of the system and how they work:

• Nurse line. Members who choose the nurse line option can receive self-care information and guidance along with advice to help them determine what setting is best to handle their health care problem, whether to take care of the problem at home or to make an appointment with their physician or go to the emergency department.

The nurses also offer lifestyle counseling, particularly involving nutrition and exercise, and offer coping tips for chronic conditions. Members can access more than 1,000 audiotapes that give a quick overview of medical conditions and various psychosocial topics.

The nurse line staff flag members who may need a follow-up and keep in touch by telephone.

• Personal consultation service. Counselors provide telephonic consultations for personal and emotional issues, including grief and loss and substance abuse. The counselors can offer up to three face-to-face visits if needed before the mental health benefit kicks in. The visits don’t count toward the member’s mental health maximum.

If the members’ needs are more complex, they can transition smoothly to the mental health visit. The counselors give members a care plan and a preliminary assessment worked out in advance. As a result, the members are able to make the best use of their mental health benefits, Schwab adds.

"I’ve never met a patient who says today is the start of my mental health problem.’ It’s usually something that has been building for a long time. We want to catch the problem before it builds into a full-blown mental health problem that is more costly to treat," she adds.

• Work-life resources. This component puts members in touch with specialists in adult care, elder care, child care and family services, educational resources, financial consultations, and legal referrals. The initial telephonic consultation is free. After that, members receive a discount on the consultations.