How a Nurse-First Triage Model Can Reduce Unnecessary ED and Urgent Care Visits

In an article with PSQH, Dusti Browning, vice president, Growth and Client Solutions at Conduit, shares that already unsustainable care costs will rise yet another 5% or higher this year, not including the increase in premiums many organizations have experienced. To counter the impact, one out of five employers point to utilization control services, including nurse advice lines that can help steer employees to the right care in the right location, as the most effective options for decreasing expenses.

The need for ED utilization solutions concerns more than just payers and employers, it’s also a priority for health care organizations. 

Dusti Browning

“While ED nursing shortages existed long before COVID-19, the prolonged stress of the pandemic—combined with the pressures of working in an emergency care environment—have prompted a higher percentage of nurses to leave the ED,” shares Dusti.

A recent study was conducted that under a Nurse-First Triage model, employees call a 24-hour service staffed by registered nurses before heading to an urgent care or ED to determine what care they need and where they should receive it.

Employers and health plans are relying on nurse-first triage to reduce health care costs and strengthen quality of care. At an average cost of $30 per visit, compared to an average ED visit cost of $1,200 to $1,400 and urgent care costs of $150 to $200 per visit, such a model can deliver strong return on investment:

  • One large Midwest health system with 35,000 covered lives decreased ED utilization from 242 visits per 1,000 associates to 192 visits per 1,000 associates.
  • Another large health system with 65,000 covered lives decreased ED visits from 229 visits per 1,000 associates to 176 per 1,000 associates.

Implementing a Nurse-First triage line can help patients determine whether chronic conditions are escalating, steps to take in managing their condition, and when interventions are needed. This solution can also offer support for patients recently discharged from the hospital to help minimize readmissions, improving health outcomes while reducing costs.

When selecting a nurse advice line, employers should keep in mind a few key considerations:

  • Ensure the line is staffed by a registered nurse.
  • Assess the partner’s familiarity with local resources.
  • Choose a program that can be branded to your organization.

Contact Conduit to learn how a Nurse-First triage model could help your organization.

Contact us today to learn how Conduit Health Partners can help your organization.