Where You Go Matters: Member education campaign focuses on level of care options

A Blue Cross and Blue Shield of Texas (BCBSTX) analysis of claims activity has shown increased utilization of emergency room services for non-emergent diagnoses. This may indicate that some of our members are selecting the ER as their first choice for care even when other settings may be more clinically appropriate.

Some patients simply may not know where else to go for care. In particular, many new members may not be aware that they have choices and can take an active role in selecting appropriate level of care settings. To help members make better-informed decisions, BCBSTX is launching a member educational initiative titled “Where You Go Matters.”

The Where You Go Matters initiative focuses on helping members understand how to determine what level of care may be most appropriate for their particular situation. Member materials describe available levels of care with examples of health care issues that can be treated in each setting. The materials also point out what the member may expect in terms of possible out-of-pocket costs, wait times and degree of personalized care.

Guidelines presented in the member materials include:

• Your Doctor Knows Best – Whenever possible, the first point of contact should be the family doctor or Primary Care Physician
• Retail Clinics – A retail or convenient care clinic, as they are sometimes called, can be a good choice for a minor health problem like a sore throat or ear infection if the doctor’s office is closed
• Urgent Care Clinics – Urgent care clinics or comprehensive care centers can give easy access to health care when the sickness or injury is serious, but isn’t life threatening
• Sometimes ER is the Only Choice – Calling 911 or going to the nearest ER is the right option when the health problem is life threatening.

Where You Go Matters was piloted earlier this year with select members who received educational information by mail and a series of emails. The campaign is being expanded in the second quarter of 2015 to target the broader member population. Materials in English and Spanish include fliers, member newsletter articles, videos and social media.

We encourage you to direct your patients to the BCBSTX provider website for general information. BCBSTX members also may log on to our secure Blue Access for Members^SM website for resources based on their specific health care benefit plans.

These programs are for informational purposes only, and are not a substitute for the sound medical judgment of a physician or other health care professional. Members are encouraged to talk to their doctor if they have any questions or concerns regarding their health.