Disease Management Update
Volume III, No. 18
August 17, 2006

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Table of Contents

  1. Health Plan Hopes Surveying At-Risk Patients Will Reduce Emergency Department Overuse
  2. Disease Management Q&A: Improving Contact with Expectant Members
  3. Health Risk Assessments: First Line of Defense in Population Health Management
  4. Health Management Program Helps Save Wyoming Nearly $13 Million in Healthcare Costs in First Year
  5. New Explanations for Obesity and Mortality in the Elderly

1.) Health Plan Hopes Surveying At-Risk Patients Will Reduce Emergency Department Overuse

In an effort to reduce unnecessary emergency department (ED) visits and to enable a more personalized, targeted service level, Keystone Mercy Health Plan will survey at-risk patients with frequent emergency room visits. Using an automated adherence outreach solution from PAR3 Communications, the survey will identify the factors that lead to the visit, educate the patient about appropriate ED utilization and deliver information about primary care physician access. Reports from the survey will help Keystone identify at-risk patients and enroll them in disease management programs that can reduce costs and improve patient health.

According to a 2006 Institute of Medicine study, there were 113.9 million ED visits in 2003, up from 90.3 million in 1993, while the total number of hospitals decreased by 703 during the same period. Adding pressure to already strained resources, todayís EDs provide much of the medical care for patients lacking commercial insurance.

To read this story in its entirety, please visit:
http://www.par3.com/pages/index.php?path=Company/Press/News%20Releases&year=&article=00055&content=comp_news_release_article.php&


2.) Disease Management Q&A: Improving Contact with Expectant Members

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Dr. Christy L. Beaudin, corporate director of quality improvement at PacifiCare Behavioral Health in Van Nuys, Calif.

Question: Do you use other methods besides mailed screening tools to contact members in the maternity management program?

Answer: We're trying to expand the services we offer patients and now include telephonic coaching, among other recently developed resources. Getting participants engaged in the program initially has been our greatest challenge, and we continue to work with the provider community on how to optimize patient outreach. This open communication proved quite successful in our general depression initiative. We partnered with group practices and made educational and screening information available at the site of service. This approach is more convenient for consumers, and itís a venue we need to explore in all program development.

To learn more about maternity management programs, including case studies of existing initiatives, pre- and post-natal assessments, care guidelines, monitoring techniques and outcomes, please visit:
http://store.hin.com/product.asp?itemid=3219

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


3.) Health Risk Assessments: First Line of Defense in Population Health Management

A powerful component of a health population management strategy is the Health Risk Assessment (HRA), which evaluates a populationís health status and targets actionable programs to address identified risks. Whether implemented by employers or health plans, developing effective HRAs and mining the resulting data is a strategic means of harnessing healthcare costs and fostering consumer awareness of their own health state. This white paper details the results of a recent Healthcare Intelligence Network (HIN) poll that gauged the presence and power of HRAs in the healthcare industry.

To download this complimentary white paper, please visit: http://www.hin.com/library/registerhra.html


4.) Health Management Program Helps Save Wyoming Nearly $13 Million in Healthcare Costs in First Year

APS Healthcare, one of the country's leading specialty healthcare companies, and the Wyoming Department of Health's EqualityCare (Medicaid) program has announced that APS' Healthy Together total population health management program helped the state avoid more than $12.7 million in unnecessary healthcare costs. These results were for the aged, blind and disabled Medicaid population in its first reconciliation year, which ended on Dec. 31, 2005.

The healthcare company managed an average of more than 7,800 Medicaid clients per month through its Healthy Together health management program, which includes programs for clients with asthma, coronary artery disease, chronic obstructive pulmonary disease, chronic heart failure, depression, diabetes and other disease states. The average cost avoidance for clients, while still maintaining quality care, was $135 each month, which was $36 above the target savings per member per month.

To read this story in its entirety, please visit:
http://www.apshealthcare.com/newsroom/2006/aug9_2006.htm


5.) New Explanations for Obesity and Mortality in the Elderly

When it comes to predicting death rates among the elderly, a new study finds it's more about where they store the fat than how much fat they have. A study published in a recent issue of the American Journal of Clinical Nutrition reveals that older people with high waist-to-hip ratios (WHRs) have a higher mortality risk than those with a high body mass index (BMI). Researchers in England wanted to know which measurement was the best way to predict mortality risks in the elderly. They compared the associations of BMI, waist circumference and WHR with mortality and cause-specific mortality. They studied 14,833 patients older than 75. The subjects underwent a health assessment, including body measurements and a follow-up for mortality.

The researchers found that BMI turned out to be a poor way to assess risk in the elderly. The researchers say current guidelines overestimate the risk of having excess body fat for men and women older than 75 years.

To read more about this study, please visit:
http://www.ajcn.org/cgi/content/abstract/84/2/449?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&volume=84&firstpage=449&resourcetype=HWCIT


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