Our client is a Medicaid Managed Long-Term Care (MLTC) payer in New York with members who are home-bound seniors with long-term care needs. When a new member joins the plan, a nurse visits them at home for an assessment to determine their healthcare needs and develop a care plan. Nurses will visit again periodically for additional assessments to ensure the member’s needs are being met over time.
This is a critical part of the care management clinical workflow, however, the client’s process for scheduling nurses for in-home assessment visits was manual and fragmented. Nurses were frustrated with schedules that took them to different corners of New York City on the same day and did not consider their location, skills, and preferences for assignments. This frustration led to constant turnover in staff and the Assessment team was unable to keep up with the rapid growth of the plan’s membership.