Disease Management Update
Volume III, No. 26
October 12, 2006

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Table of Contents

  1. More Employers Using Health Risk Assessments to Pinpoint Potential Disease Management Participants
  2. Disease Management Q&A: Dissecting the ROI of Health Risk Assessments
  3. New! HealthSounds Podcast: After the HRA: Implementing a Healthcare Risk Stratification Strategy
  4. Coaching Care Can Help Cut Medical Costs
  5. Health Risk Assessments: First Line of Defense in Population Health Management

1.) More Employers Using Health Risk Assessments to Pinpoint Potential Disease Management Participants

As employers continue to look for ways to control rising healthcare costs, an increasing number are offering employees incentives to complete a health risk assessment or appraisal (HRA). The Watson Wyatt/National Business Group on Health report shows that two-thirds of employers offered employees an HRA this year, and another 21 percent plan to offer them in 2007. In return for completing this health self-assessment, employers usually offer workers incentives such as financial rewards. The HRA helps companies identify workers for participation in various disease management programs.

To read this article in its entirety, please visit:
http://www.watsonwyatt.com/news/press.asp?ID=16571


2.) Disease Management Q&A: Dissecting the ROI of Health Risk Assessments

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Roger Reed, executive vice president for market operations at Gordian Health Solutions.

Question: Given that HRAs may include up to 40 data points ó claims, pharmacy, health events, etc. ó what specifically do you analyze to determine ROI?

Answer: We use total paid claims per member as a baseline. This measure includes every filed claim in that memberís case history so we can assess for comorbid conditions. Past studies used only disease-specific claims to calculate ROI. More recently, the Disease Management Association of America (DMAA) recommends that all paid claims be integrated into ROI pre- and post-analysis. We identify at-risk individuals, separate them into cohorts and place them in lifestyle management programs. We then match a non-participant group to one of these experimental cohorts through propensity scoring and characteristics such as age, sex, diagnosis and past claims. That gives us a match case-control group of those that have elected not to participate within the same population as our experimental cohort.

We analyze baseline medical claims, including inpatient, outpatient, pharmacy, etc. We measure time one scores versus time two scores. The difference between the match case-control group and the intervention group becomes the actual savings. Thus, the savings dollars are the differences in outcome for those who have had the intervention and those that have not. Except for out-of-pocket contributions, we consider all medical expenses in this analysis.

To learn successful strategies for implementing effective HRAs and mining the resulting data to harness your organization's healthcare costs and promote consumer awareness, please visit: http://store.hin.com/product.asp?itemid=3287

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


3.) New! HealthSounds Podcast: After the HRA: Implementing a Healthcare Risk Stratification Strategy

In this week's Disease Management podcast, you'll hear Penelope Kokkinides, national vice president of disease management with AmeriChoice, a United Healthcare Company, describe the initial steps in crafting a healthcare risk stratification strategy and Thomas Ferraro, business development director with Mayo Clinic Health Management Resources, provide insights on the stratification process within his organization.

To listen to this complimentary HIN podcast, please visit: http://www.hin.com/podcasts/podcast.htm#13


4.) Coaching Care Can Help Cut Medical Costs

Healthcare transition coaches who encourage people to take a more active role in maintaining their health can help reduce patients' hospital bills and rates of re-hospitalization, according to a University of Colorado at Denver and Health Sciences Center study. The coaching program is designed for patients who require treatment in multiple sites of care.

The healthcare transition coach works with patients on four main areas: medication self-management; the creation of a personal health record maintained by the patient; obtaining timely follow-up care; and developing a plan to seek care if certain symptoms appear. The coach keeps in contact with patients across different healthcare settings in the first 30 days after they're discharged from the hospital.

To read this story in its entirety, please visit:
http://www.uchsc.edu/news/newsrelease/2006/sep/25-CareTransitions.htm


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

More and more healthcare organizations are placing HRAs on the front lines of their population management efforts. Whether on paper or online, HRAs are being used by these companies as a screening tool to label an individualís health status. The findings from an HRA help identify a personís health risk status, the first step in mapping out a complementary wellness and/or disease management program.

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


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