The call itself is a golden opportunity for the plan to establish rapport with a member, solve his or her dilemma, and create a memorable positive experience. Multiple Analyses Broaden View of Successful Redirection Health plans, hospitals, and physician groups repeatedly report the success of nurse triage in averting unnecessary and costly emergency room visits. The Arizona study corroborates this. Sixty-five percent actually performed these lower cost levels of care. The purpose of nurse triage is to direct callers to the medically appropriate level of care whether that is the emergency room, a physician visit, or self-care.
Cost savings derive from medically appropriate care and appropriate utilization of resources.
For instance, redirecting a person to the emergency room may be cost-effective in the long run because it prevents more serious problems. By analyzing redirection to higher as well as lower levels of care, the Arizona study presents a comprehensive view of triage effectiveness. Twenty percent followed the recommendation by calling 911 or going to the emergency room. Eighteen percent of them sought emergency care. Table 1 shows the levels of care that callers obtained following triage counseling, in comparison to the care they were inclined to pursue.