Disease Management Update
Volume V, No. 13
July 24, 2008

Dear Healthcare Intelligence Network Client,

This week we're reporting live from the 13th annual Health Management Congress in Orlando. Against the backdrop of the 2008 presidential election, the congress's opening speakers talked about the healthcare issues we won't hear the candidates talking about — safety and security surrounding PHRs, dwindling numbers of PCPs and nurses, a lack of substantive research on how to change behavior and the impact of baby boomers on the healthcare system.

But in opening sessions and conversations with attendees, we're hearing about some initiatives that can make a difference: a winning predictive modeling-health coaching model, a "virtual" medical home for the Medicaid population that successfully addresses the 20 percent with behavioral healthcare issues and a New Jersey health plan that will soon place caseworkers at employer sites as part of its "Case for Wellness" initiative.

Read the HIN blog for daily posts from the congress and tell us what you think about their initiatives.

Also in this edition, new research suggests a mother's weight could have an effect on the weight of her child.

Your colleague in the business of healthcare,
Laura Greene
Editor, Disease Management Update

If this is a forwarded copy of Disease Management Update and you like what you see, you can register to receive your own copy of this complimentary service. Sign up at: http://www.hin.com/dmdesktop/diseasemanagement.html

Table of Contents

  1. Live from the Health Management Congress: High-risk Hoosiers Encouraged to Tell Own Health Story from First Coaching Call
  2. Disease Management Q&A: Coordinating Interventions in Overweight Children
  3. HealthSounds Podcast: Live Health-coaching Session for Weight Management
  4. Epigenetics Could Promote Obesity in Next Generation
  5. Survey of the Month: Energy Costs in Healthcare
  6. Employer-sponsored Weight Management Programs — The Business Case

1. Live from the Health Management Congress: High-risk Hoosiers Encouraged to Tell Own Health Story from First Coaching Call

The "secret sauce" in CARE GUIDE's survey-based predictive modeling program supported with health coaching began saving the state of Indiana money after only six months by reducing healthcare encounters by the coached individuals. Jim Kenney, M.S., CARE GUIDE's director of health coaching, and Jim Kerr, the company's vice president of business development, shared the details of this initiative with population health and disease management specialists this week during a pre-conference workshop of the 13th Annual Health Management Congress.

Escalating healthcare costs and an unhealthy population prompted Indiana state officials to engage CARE GUIDE, who customized a health survey for the 45,000 state employees and spouses. Buoyed by strong leadership support that started with the governor, intense employee communication (486 meetings around the state to introduce the program) and powerful cash incentives, the program enticed more than 54 percent of the population to take the health assessment.

Predictably, about one-fifth of these participants were identified as high risk. But the health coaching effort that followed, which focused less on clinical compliance than on participants' readiness to change, successfully engaged more than 90 percent of the high-risk employees in its first year. The program has maintained these levels of engagement in its second year.

by Patricia Donovan

To learn more about this initiative, please visit:

2. Disease Management Q&A: Coordinating Interventions in Overweight Children

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Dr. Eric Berman, D.O., M.S., medical director, Horizon Blue Cross Blue Shield of New Jersey.

Question:What initiatives have been enacted by health plans to furnish reimbursement or financial incentives to providers for investing the extra time and resources needed to implement and coordinate effective health interventions in overweight children?

Response: (Dr. Eric Berman) That is an area where most health plans are woefully inadequate. Our health plans do not reimburse pediatricians for addressing obesity as a primary diagnosis, which is a big problem. One way to address this is to develop regional programs in weight management. Horizon has developed a Health and Wellness Education program for our HMO members that is a self-referred program for members aged 12 or older.

Members can call and have a frank discussion with a nurse who will either direct them to a registered dietician or exercise physiologist or hear out their concerns and develop a weight-loss program for them to start exercising and eating right.

In Atlantic County, New Jersey, we are developing an entire wellness program that includes children and adults. There are specialized classes for children on exercise and food selection.

We’re also looking into rewarding our members who are able to lose weight and keep the weight off. WellPoint and possibly Blue Shield of California have embarked on similar programs where they are starting to give people reductions in their premiums or cash bonuses. If they are able to lose 10 to 15 pounds, they receive a reduction of $200 to $500. If they keep the weight off for another six months, they get a second payment of equal amount. Many health plans are looking at this and over the course of the next few years, there will be more and more plans offering some kind of bonuses for people who are starting to adapt these more healthful behaviors.

For more details on weight management, please visit:

We want to hear from you! Submit your question for Disease Management Q&A to info@hin.com.

3. HealthSounds Podcast: Live Health-coaching Session for Weight Management

In a live coaching demo, "Coach Meg" (Wellcoaches CEO Margaret Moore) helps volunteer client Kathy Smith (not her real name) identify life issues that are keeping her from being her "best self" in managing her thyroid condition and weight issues. You'll hear how Coach Meg builds positive psychology into this real-life health coaching session.

To listen to this complimentary HIN podcast, please visit:

4. Epigenetics Could Promote Obesity in Next Generation

Overweight mothers give birth to offspring who become even heavier, resulting in amplification of obesity across generations, said Baylor College of Medicine researchers in Houston who found that chemical changes in the ways genes are expressed — a phenomenon called epigenetics — could affect successive generations of mice.

Researchers studied the effect of maternal obesity in three generations of genetically identical mice, all with the same genetic tendency to overeat. One group of mice received a standard diet; the other a diet supplemented with the nutrients folic acid, vitamin B12, betaine and choline. The special 'methyl supplemented' diet enhances DNA methylation, a chemical reaction that silences genes.

"There is an obesity epidemic in the United States, and it's increasingly recognized as a worldwide phenomenon," said Dr. Robert A. Waterland, assistant professor of pediatrics and lead author of the study. "Why is everyone getting heavier and heavier? One hypothesis is that maternal obesity before and during pregnancy affects the establishment of body weight regulatory mechanisms in her baby. Maternal obesity could promote obesity in the next generation."

To learn more about this research, please visit:

5. Survey of the Month: Energy Costs in Healthcare

According to the Environmental Protection Agency, healthcare organizations spend over $6.5 billion on energy each year to meet patients' needs while experiencing double-digit cost increases. In addition, rising gas prices are affecting healthcare administration and utilization. Complete our survey on energy costs in healthcare by July 31 and receive a free summary of the compiled results and $25 off the price of the full study when it is published in September. Also, the respondent who submits the most effective energy conservation/cost-saving strategy will receive a $50 gas card!

To participate in this survey and receive its results, please visit:

6. Employer-sponsored Weight Management Programs — The Business Case

This white paper details the significant benefits to organizations that invest in proven weight control strategies at work. The paper cites more than a dozen studies highlighting the ROI in terms of health risks, costs and worker productivity and offers employers solutions to the growing crisis.

To download this complimentary white paper, please visit:
Please forward this news announcement to your colleagues who might find it useful.
Contact HIN:
Editor: Laura M. Greene, lgreene@hin.com;
Sales & Marketing Coordinator: Deirdre McGuinness, dmcguinness@hin.com;
Publisher: Melanie Matthews, mmatthews@hin.com

For more information on the products and services available through the Healthcare Intelligence Network, contact us at (888) 446-3530 / (732) 528-4468, fax (732) 292-3073 or email us at info@hin.com.
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