Nurse Support for Members with Chronic Conditions

The Blue Cross and Blue Shield of North Carolina (Blue Cross NC) disease management program, known as our Nurse Support Program, is comprised of a multi-disciplinary team designed to connect with members during impactable moments. This multi-disciplinary team includes pharmacists, registered dietitians, social workers, and certified diabetes care and education specialists in addition to nursing support.  

Our program aims to achieve the following goals

• Educate and provide the member with tools to better manage their condition 
• Foster the relationship between the member and their primary care provider (PCP) 
• Close gaps in care with an overall focus on improving the member experience and quality of life  
• Reduce risk of readmission and inappropriate emergency room utilization related to chronic conditions 

This resource is available for Administrative Services Only (ASO) and fully insured groups, and individuals under 65. 

Identifying and Managing Members 

Predictive modeling tools that gather data from academic expertise, clinical leadership, artificial intelligence and machine learning allow us to not only identify high-risk members, but also members with rising risk. A new diagnosis of a chronic condition or an emergency room visit and/or inpatient admission can be confusing and overwhelming. With guidance from the Nurse Support Program, members can receive education and tools to better manage their condition and improve their quality of life. The guidance from this program is meant to help support and reinforce the care plan established by the members’ PCP. The Blue Cross NC Nurse Support Program is built on a foundation of two critical encounters with members:  

1. Outreach to members after an emergency room visit or inpatient admission associated with a targeted condition. 
2. Outreach to members who have a new diagnosis related to a targeted condition. 

These critical encounters are designed to improve the member experience and provide enhanced support. For questions or more information about our Nurse Support Program, please call 888-229-8510. 

This update is for information purposes only. No further action is required.