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Member Update - April 2024

Reminder: Any orthopedic or other specialty care outside of Yale Health Center requires a referral from your PCP. Yale New Haven Health recently sent a solicitation that included some Yale Health members about utilizing their outpatient orthopedic care center in North Haven. Such a center requires an approved referral for Yale Health members.

Availability of GLP-1 Medications

There continues to be global shortages of injectable medications used to treat diabetes and support weight management (e.g., Ozempic, Wegovy, Trulicity, Mounjaro, and Zepbound).

We know that for many of our members, these medications are a valuable part of their care. At the same time, others are considering medications in these classes with their clinicians or waiting for the opportunity to start treatment. For both groups, the ongoing shortages have been challenging and frustrating.

In the face of significant supply constraints, we are prioritizing maintaining access to these long-term treatments for those already taking them. There continues to be a 30-day limit on prescriptions to help support equitable access for all. 

For individuals newly starting these medications, the current supply is limited and available only for those in the greatest need due to higher BMI, diabetes, or serious cardiovascular disease. While recognizing that others will benefit from these medications, we have had to prioritize those at greatest risk. Our pharmacy team continues to maintain supply and as it improves, we plan to expand access for new starts incrementally based on risk and associated health conditions.

Our clinical teams have a variety of medication and non-medication resources to support you with your health and wellness and we appreciate your ongoing partnership as we navigate these global shortages.

Telephone Service Upgrade

As we continue to improve access to Yale Health, we’d like to share an early success story. Our new telephone system, designed to handle the increased volume of calls coming into Yale Health, is off to a great start. Our wait times have improved significantly impacting our overall service level for all members. We are fully aware of the frustrations many of our members experienced with our previous phone system, often leading to high abandonment rates (caller hangs up) and repeat calling. Our abandonment rate has gone from 25% during the pandemic, to a current low of 3%. Our staff is excited to be able to provide this improved service.

We appreciate member feedback to improve our member experience and have a few updates to share with you:

  • One new feature to try is our new “call back” option. This functionality eliminates the need to wait in a queue. You will keep your place in line, and when a navigator or Yale Health representative is available, you’ll receive a callback.
  • This updated telephone system was also implemented in Claims & Referrals, Member Services, Health Information Management, and Mental Health & Counseling.
  • In late spring, we plan to add an option for callers to utilize conversational artificial intelligence (AI) with virtual assistants to support many common questions or needs from callers.

We Value Your Input

Yale Health’s Patient & Family Council is growing. As you may know, the Council has been a resource and sounding board for Yale Health in a wide range of matters affecting patients, patients’ families, and Yale Health staff. The council members work together to review and advise the Yale Health leadership on operational processes and programs to address the needs of patients and families.

The council also facilitates discussion regarding healthcare services within the context of Yale Health and the greater healthcare environment. Some members also have an advisory role in providing feedback on relevant projects undertaken by Yale Health.

We hope you will consider joining us as a patient partner as we work together toward a better Yale Health. This is a great opportunity for new and seasoned members to come together to continue enhancing Yale Health’s care and services. Apply today to be a patient partner.

Member Coverage Booklet Available Online

Remember to periodically check your Employee Member Coverage Booklet to review your coverage at Yale Health and yearly updates. The booklet, redesigned for 2024, is a comprehensive explanation of the benefits and coverage provided under your Yale Health employee coverage.

The booklet describes the rights and obligations of you and Yale Health, what the plan covers, and how benefits are paid for that coverage.

Our Member Services team is happy to assist you with any questions about the booklet and your coverage.