Increasing nurses’ time with members and reducing staff turnover at a Medicaid MLTC plan



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.


Anoteros was hired as a consulting partner to solve the problem. Our team documented the current state processes, identified the inefficiencies, and produced a comprehensive recommendation to improve the scheduling process. Based on our recommendation, the client selected Salesforce as the technology to automate the scheduling of assessment visits, due to its robust field service management capability. We helped the plan select a Salesforce implementation vendor and led the design of a robust solution. The solution mapped member needs with the skills and location of the nurses and provided automated scheduling capability. The solution also integrated DocuSign with Salesforce for e-signatures, and eliminated the paper forms, mini scanners, and printers that the nurses previously carried to the home visits.


The new system enabled the Assessment unit to increase the number of daily in-home assessments by 40%, ensuring members’ needs were identified in a more timely manner. Nurses now spend most of the day using their clinical talents in visits with members because the time spent traveling between appointments is significantly reduced. In addition, an automated scheduling solution is scalable, so the plan was able to add delegated vendors to perform services in newer markets without any additional investment in technology.