Attachment D Nurse Line Utilization.pdf
PDF 450 KB Posted
- Attached to
- Third Party Administrator
- Solicitation number
- S000000375
- Issued by
- Arkansas
About this file
This is a NurseLine Utilization Report for Arkansas Blue Cross Blue Shield (BCBS) ASE/PSE covering Q4 2024 (October 1, 2024 to December 31, 2024). The report shows utilization metrics for a member population of 146,486 in Q4 2024, with 321 total contacts, 277 unique participants, and 353 total services provided. The service data indicates that triage services comprised 74% of all contacts, followed by member information (23%), health information (11%), and program referrals (2%). The report demonstrates a consistent quarterly utilization rate around 0.8-0.9% for contacts and 0.7-0.8% for unique participants.
The demographic data shows that 68% of users were female and 32% male, with the majority of users falling in the 50-64 age range (34%), followed by 36-49 (23%) and 21-35 (18%). The triage pre-intent data reveals that 80% of callers initially intended to visit the emergency room, but nurse recommendations redirected many to more appropriate levels of care. Program referrals had a 100% acceptance rate in Q4 2024, with Customer Service being the most common referral type (5 referrals), followed by External Behavioral Health Program and External Care Management (1 referral each).
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment B Business Associate Agreement.docx | DOCX document | |
| S000000375 Official Solicitation Price Sheet.xlsx | XLSX spreadsheet | |
| Attachment F Introduction to EAP.pdf | ||
| Attachment C Three-Digit Zip Code Analysis.xlsx | XLSX spreadsheet | |
| S000000375 Third Party Administrator~3.pdf | ||
| Attachment G Performance Standard Examples.pdf | ||
| S000000375 TPA Questions and Answers Final.pdf | ||
| Attachment A Non-Disclosure Agreement REV.docx | DOCX document | |
| S000000375 Services Contract SRV-1 Sample.pdf | ||
| S000000375 Technical Proposal Packet.docx | DOCX document | |
| Attachment E EAP Utilization Report 2024.pdf | ||
| S000000375 Official Solicitation Price Sheet REVISED.xlsx | XLSX spreadsheet | |
| S000000375 Third Party Administrator REVISION TWO.pdf | ||
| S000000375 Contract and Grant Disclosure.pdf | ||
| Attachment A Non-Disclosure Agreement.docx | DOCX document | |
| Attachment C Three-Digit Zip Code Analysis REVISED.xlsx | XLSX spreadsheet |
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Text version
NurseLine Utilization Report
Arkansas BCBS - ASE/PSE Report Run Date: 1/15/2025 11:40:00 AM
Request Id: 26290
Period: 10/1/2024 to 12/31/2024
Time Interval: Quarterly
Population Type: Member
Utilization and Contact Summary
Utilization Summary
20,000
40,000
60,000
80,000
100,000
120,000
140,000
160,000
0%
5%
10%
15%
Q4-2023 Q1-2024 Q2-2024 Q3-2024 Q4-2024
P o p u la ti o n
P e rc e n ta g e
Population Annualized Contact Utilization %
Annualized Participant Utilization %
Repeat Participant %
Q4-2023 Q1-2024 Q2-2024 Q3-2024 Q4-2024 YTD
Population 144,053 148,449 148,294 146,064 146,486 147,323
Contacts 280 299 309 304 321 1,233
Annualized Contact Utilization % 0.8% 0.8% 0.8% 0.8% 0.9% 0.8%
Unique Participants 252 267 273 263 277 994
Annualized Participant Utilization % 0.7% 0.7% 0.7% 0.7% 0.8% 0.7%
Repeat Participant % 8.3% 9.4% 9.5% 13.3% 10.8% 15.3%
Services 322 316 350 335 353 1,354
Services per Contact 1.2 1.1 1.1 1.1 1.1 1.1
Contact Summary
0.0
0.5
1.0
1.5
Q4-2023 Q1-2024 Q2-2024 Q3-2024 Q4-2024
S e rv ic e s p e r
C o n ta c t
T o ta l
Contacts Unique Participants Services Services per Contact
Service Summary
Services
% Total
Contacts Services
% Total
Contacts Services
% Total
Contacts Services
% Total
Contacts Services
% Total
Contacts Services
% Total
Contacts
Triage 219 78% 208 70% 229 74% 237 78% 238 74% 912 74%
Program Referral 8 3% 9 3% 7 2% 4 1% 7 2% 27 2%
Health Information 28 10% 26 9% 28 9% 39 13% 35 11% 128 10%
Member Information 67 24% 73 24% 86 28% 54 18% 73 23% 286 23%
Member Communication Request 0 0% 0 0% 0 0% 1 0% 0 0% 1 0%
Total 322 316 350 335 353 1,354
Q4-2024 YTDQ4-2023 Q1-2024 Q2-2024 Q3-2024
Services as a % of Total Contacts
Q4-2024
74%
23%
11%
2%
Triage
Member Information
Health Information
Program Referral
Subject Demographics
By Gender Q4-2023 Q4-2024 YTD
Male 33% 32% 32%
Female 67% 68% 68%
Not Reported 0% 0% 0%
By Age Range Q4-2023 Q4-2024 YTD
Under Age 3 5% 4% 4%
3 - 10 6% 5% 5%
11 - 20 10% 8% 10%
21 - 35 14% 18% 16%
36 - 49 19% 23% 22%
50 - 64 37% 34% 36%
65 - 70 6% 5% 4%
71 - 75 2% 1% 2%
76 - 85 0% 2% 1%
85+ 1% 0% 0%
Not Reported 0% 0% 0%
By Caller Relationship to Subject Q4-2023 Q4-2024 YTD
Self 77% 82% 79%
Parent 14% 11% 13%
Spouse 5% 4% 4%
Other 1% 1% 1%
Guardian 0% 0% 0%
Family Member 4% 2% 3%
Caregiver 0% 0% 0%
Not Reported 0% 0% 0%
Provider Referrals
Referrals to Physician Specialties Q4-2023 Q4-2024 YTD
Total Physician Specialty Referrals 0 0 0
Referrals to Facilities Q4-2023 Q4-2024 YTD
Total Facility Referrals 0 0 0
Program Referrals
Program Integration Summary Q4-2023 Q4-2024 YTD
Total Number of Program Referrals 8 7 27
Total Number of Accepted Referrals 7 7 27
Referral Acceptance Rate (% of accepted program referrals out of total program referrals) 87.5% 100.0% 100.0%
Referral Identification Rate (% of participants with a program referral) 3.2% 2.5% 2.3%
Top Ten Program Referral Types - Q4-2024 Referred Accepted % Accepted
Customer Service 5 5 100%
External Behavioral Health Program 1 1 100%
External Care Management 1 1 100%
Triage Pre-Intent with Nurse Recommendation
50%
45%
34%
50%
24%
38%
80%
85%
23%
8%
14%
3%
47%
29%
4%
3%
21%
37%
45%
44%
24%
33%
14%
10%
6%
9%
7%
3%
6%
2%
1%
0 20 40 60 80 100 120 140
Q4-2024
Q4-2023
Q4-2024
Q4-2023
Q4-2024
Q4-2023
Q4-2024
Q4-2023
ER UC MD Office Self-Care | Total
Pre-Intent Self-Care, Do Nothing, Don’t Know
Pre-Intent MD Office
Pre-Intent UC
Pre-Intent ER
Nurse Recommendations:
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