State of Colorado to offer IAS medical advice line to Medicaid clients.

BOULDER, Colo.--(HealthWire)--May 22, 1996--The Colorado Medicaid program will soon offer a telephone triage/medical advice telephone line to help Medicaid clients access appropriate health care services.

The new service, Colorado Medicaid FirstHelp(TM), will be provided through a contract with Informed Access Systems Inc. (IAS) of Boulder, with oversight provided by the Colorado Foundation for Medical Care (CFMC). The Colorado Medicaid program is administered by the Department of Health Care Policy & Financing (DHCPF); CFMC is the Department's peer review organization.

Beginning June 1, 1996, DHCPF will offer Colorado Medicaid FirstHelp(TM) services at no charge to 40,000 Medicaid clients who are not currently enrolled with a managed care plan in the following six counties: Denver, Boulder, Arapahoe, Douglas, Jefferson and Adams.

The purpose of the telephone triage/medical advice line is twofold: (1) to provide Medicaid clients with an alternative to emergency department care and reduce inappropriate utilization of emergency services, and (2) to inform Medicaid clients of the state requirement to select a managed care provider.

Under this plan, Medicaid clients who need medical care can call a toll-free number 24 hours a day, seven days a week, speak with a registered nurse about their symptoms, and receive a recommendation on care options. The nurse will also inform clients of the state's requirement to enroll in a managed care plan or with a primary care physician.

"This service should improve access to appropriate care for Colorado Medicaid clients," says Richard C. Allen, director of the Office of Medical Assistance.

Only Medicaid clients who have not selected a managed care provider are eligible for the service. Clients who have enrolled with a Medicaid HMO or who have selected a Primary Care Provider (PCP) are expected to contact their respective HMO or PCP for medical advice. Medicaid clients will be informed of the FirstHelp service and receive information on how to access the service through a series of mailings.

This pilot project grew out of recommendations that were made in 1994 to the Colorado Dept. of Health Care Policy & Financing by an Emergency Services Task Force, the Colorado Medicaid Reform Study and the medical community. Based on those recommendations, the Department requested funding from the Colorado Legislature to offer a medical advice line to Colorado Medicaid clients. Funding for a pilot project was awarded last year; a cost-effectiveness study is due to the Legislature Feb. 1, 1997, which will determine the cost-effectiveness of the service and the feasibility of expanding it statewide.

"Colorado Medicaid FirstHelp will offer Medicaid clients a readily available source of health care advice and information on managed care options," notes Joseph P. Tallman, president of IAS. "We expect the FirstHelp service will play an important role in reducing inappropriate emergency department utilization and cutting the state's health care costs, while keeping the health care safety net in place for individuals and families eligible for Medicaid."

IAS' FirstHelp service is being widely used by health care providers and health plans both nationally and internationally to assist members and patients in accessing appropriate medical care services. Health plan members are provided with a toll-free number to call if they are experiencing symptoms or have a health-related question, 24 hours a day, seven days a week. The calls are answered by IAS-trained registered nurses who use FirstHelp's clinical algorithms to guide patients to the appropriate level and source of care, including self-care.

Informed Access Systems Inc., a privately held health care information services firm, is an innovator in the growing field of care coordination. IAS's FirstHelp service is being used by a range of health care systems and health care payers, including Columbia/HealthONE of Denver, Blue Cross of California, Blue Cross and Blue Shield of the National Capital Area, D.C., Chartered Health Plan of Washington, D.C., Oxford Health Plans of Norwalk, Conn., The George Washington University Health Plan, Intermountain Health Care of Salt Lake City, American Medical Security of Green Bay, Wis. and Camino Healthcare of Mountain View, Calif.

CONTACT: Informed Access Systems Inc., Boulder

Mike Myers, 303/443-4600

Public Relations for Informed Access Systems Inc.

Jean T. Barrett, 213/851-5204 (Los Angeles)

Colorado Dept. of Health Care Policy & Financing

Donna Allen, 303/866-2220