Janet Duni was calling her highest-risk and sickest patients, asking them how they felt and whether they needed help.
The nurse came to a veteran in his 70s who had a series of problems — hypertension, depression and a chaotic mix in his medicine cabinet — plus no way to get to his doctor’s office.
Duni arranged for a driver to take him to her office at Town Medical Associates in Verona. The man brought his medications, which were prescribed independently by the VA, his primary-care doctor and physicians he encountered in a recent hospital trip.
“It was like a Bloomingdale’s big bag,” Duni recalls. “I just started throwing out the expired ones and checking the counter-indications on the others, and we cut most of them out. … He walked out of there with a tangible change.”
The state’s largest health insurer is investing in nurses such as Duni, whose role is known as a patient-care coordinator, as it revamps the delivery of health services. Horizon Blue Cross Blue Shield of New Jersey unveiled a new program Wednesday that it says will bolster primary-care doctors’ offices in the state — and provide a foundation for health care reform.
Working with Horizon, Rutgers’ College of Nursing is instituting a curriculum training nurses to be patient-care coordinators — part social worker, part problem solver — who proactively reach out to patients to keep them healthy and treated before they need a costly trip to the hospital.
An initial group of 37 nurses is undergoing the 12-week training now, and there will be a total of 200 over two years, according to Horizon, which is funding the program.
Horizon said it has put a “multimillion-dollar” investment into the program that Duke University’s School of Nursing developed. The company said its investment will be returned many times over in savings on health care spending.