Health plan launches stress management service

Program takes a proactive approach

When members call the Blue Shield of California Lifepath Adviserssm line, they can get answers to health and wellness questions from a registered nurse, speak to a mental health counselor, or consult with a specialist on everything from childcare to legal and financial questions.

The program, launched in July 2002, takes a proactive approach to dealing early on with problems that affect members’ health.

"Clinical research shows that there are a large number of primary care visits for psychosocial problems and stress over life events. We decided that our members shouldn’t have to wait until something is big enough to go the doctor’s office. Instead, we want to help people as early as possible to find personalized solutions for their specific issues," says Deborah Schwab, MS, RN, director of new product development for the San Francisco-based health plan.

The seeds for the Lifepath Advisers program came as the result of market research during which members were asked what their biggest concerns were and how Blue Shield of California could help.

Their No. 1 request was for help with problems that took away from their job, such as finding resources to care for older adults and children, followed by access to nurses or counselors outside of regular business hours.

The members asked for support services in the event of the death of a loved one and social support when moving or leaving school.

The innovative evidence-based service, Lifepath Advisers, gives members access to registered nurses- and masters-level counselors 24 hours a day, seven days a week for consultation, assessment, and referrals on a wide range of services.

"We are encouraging members to access our care early on so we can catch problems before they become more complex," Schwab says.

The new program brought together a number of disjointed services, Schwab says. Members can call one telephone number and have the option of speaking with a nurse, a counselor, or a number of specialists who can help with child care, elder care, legal, and financial issues.

"What makes it powerful is that no matter which one they select as a starting point, they receive an assessment, a high-level action plan, and assistance with navigation. If they select the nurse’ option but also feel a personal consultation with a counselor is advisable, they can be patched in on the spot," Schwab says.

The program was designed to limit system fragmentation and to decrease the potential for members falling through the cracks.

For instance, if a member talks with a counselor and realizes after a few telephone calls that he or she needs to tap into the mental health benefit, the member continues with the same counselor but merely transitions into the mental health benefit.

"Often, people don’t know where to go to get into the health care system other than to go to the emergency room or the doctor’s office. These services are a great place for them to start. They get an assessment and a plan of care so they know the wisest use of the system resources," Schwab says.

The benefit to members and employer groups is that they have only one relationship to manage. The price point is lower than if the employer contracted for the individual services because of the health plan’s purchasing power, she adds.

The health plan built coordination among vendors into the system and created flags when members call in so whomever they talk to can refer them to other areas as well. For instance, if a member calls about a problem and mentions a chronic illness such as diabetes or asthma, the member is referred to the disease management program.

The nurse liaison who runs the program receives daily reports from vendors about the reason people are calling. She works with the Blue Shield of California in-house case managers and notifies them of any patterns in calls and of individual members who may need service from the case managers.