Nurse telephone screening of new Medicare HMO members: a pilot program

Members newly enrolled in an HMO and covered under a Medicare risk contract were screened over the telephone by a registered nurse within their first month of membership to assess whether screening could lead to early intervention and later reduce utilization of health care services. This pilot study screened 36 patients (mean age = 71 years) constituting 25.2% of the new Medicare members during the period of study. Health care encounters were tracked for the first 6 months of membership. A historical comparison group included 32 patients (mean age = 72.6 years) who had enrolled 1 year earlier. A retrospective chart review determined the number of health care encounters during the comparison group's first 6 months of membership. Episodes of health care service utilization were fewer among the screening group than among the comparison group in all areas studied. This pilot study suggests the potential benefit of screening and early intervention by health care providers.