A qualitative evaluation of patient-perceived benefits and barriers to participation in a telephone care management program

Purpose. To examine why high-risk individuals targeted for a telephone care management program participated at low rates. Design. Study design consisted of qualitative, semistructured interviews. Setting. The setting was a large national insurer's telephone-based care management program. The program employed registered nurses to provide individually tailored education and counseling about health and health care. Subjects. Study subjects comprised members of a national insurer who were recruited to participate in a care management program but had either dropped out of the program after a short period of initial engagement or had never participated despite recruitment efforts. Measures. Interview content was divided into four categories: knowledge of the case management program, barriers to program participation, perceptions of benefits of the program, and suggestions for program improvement. Analysis. Investigators conducted a directed content analysis. Results. The most commonly cited barriers to participation were a lack of perceived need and a sense of distrust toward the program and its staff. The most commonly cited benefits were psychosocial support and goal setting. Conclusion. Care management programs may benefit from changes to how insurance plan members are selected for the program and from adjusting program content to address perceived needs among members.