Nurse First

What is Nurse First?
Nurse First is Montana Medicaid’s demand management program that empowers patients to become more active in their health care and provides assistance to providers in managing their care. The goal is to improve patient health status, assure access to quality care, and reduce avoidable visits and admissions. Nurse First consists of a nurse advice line, disease management and the Team Care Program.

Nurse First Advice Line. The advice line is a 24x7, toll free and confidential nurse triage line staffed by licensed-registered nurses. Eligible patients are encouraged to call when symptomatic, before making appointments or visiting an urgent care or emergency room. The nurses assess the symptoms, then provide a care recommendation to seek services at the appropriate time and level of intervention. Nurses do not diagnose nor provide treatment. The service is voluntary though strongly encouraged.

Benefits to providers:

  • Decreases evening/weekend on-call traffic
  • Reduces no show rates
  • Allows providers to focus on higher acuity patients
  • Safely reduces avoidable healthcare utilization
  • Less PHONE traffic

Montana Health and Wellness Information. The Montana Health and Wellness Information website contains a knowledgebase on thousands of health topics including health conditions and diseases, medical tests and medications. A symptom checker uses a body template to help you associate symptoms with detailed information on health conditions. In addition, an audio library is available to listen to information on many of the website’s health topics.

Disease Management. Disease Management emphasizes prevention of disease-related exacerbations and complications using evidence-based guidelines and patient empowerment tools. Our programs are designed to improve patient adherence to provider treatment plans and improve healthier living behaviors. Nurse First provides patients individualized counseling and education through face-to-face and telephonic interaction with specially trained registered nurses. Patients diagnosed with asthma, diabetes, congestive heart failure and pain may be eligible for the voluntary programs.

Team Care Program. Team Care is a program for clients who use more medical services than the average client indicating they need assistance in learning how to use their Medicaid benefits the right way.  Clients enrolled in the program receive education about how to get the right care at the right time at the right place. 

Medicaid clients in Team Care are enrolled with one provider, “locked-in” to one pharmacy to receive all Medicaid prescriptions, and are encouraged to call the Nurse First Advice Line prior to seeking services.  When a Team Care client contacts the Nurse First Advice Line a fax is sent to the office of the client’s Team Care provider.  The fax contains information about the reason for the call and whether or not the nurse advised the client to seek health care services.   

For more information about Team Care contact the Medicaid Help Line at 1-800-362-8312 or go to the website at www.mtmedicaid.org.

For more information on Nurse First program services contact the Nurse First Program Officer at (406) 444-4540.