Disease Management Update
Volume III, No. 34
December 14, 2006

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Table of Contents

  1. Conversion Map Tools Engage Diabetes Patients in Sustainable Behavior Change
  2. Disease Management Q&A: Establishing a Telephonic Presence
  3. HealthSounds Podcast: Integrating Health Coaching Into a Comprehensive Health Management Effort
  4. Retirees Benefit from HRA-Driven Wellness Programs
  5. Changing Lives with Lifestyle Management: Taking the Pulse of Population Health Programs

1. Conversion Map Tools Engage Diabetes Patients in Sustainable Behavior Change

Diabetes Conversation Map tools effectively engage patients and are aligned with the reimbursement curriculum for healthcare professionals as defined by Medicare, according to the tools' co-developers, the American Diabetes Association (ADA) and Healthy Interactions, Inc. The developers seek to transform how diabetes educators and other healthcare professionals engage patients in learning about diabetes and making lifestyle modifications that lead to improved self-management.

The diabetes Conversation Map tools, with content developed and reviewed by the ADA, are scheduled to be launched across the United States in 2007, initially being offered to 2,800 ADA-recognized diabetes education programs as well as to other healthcare professionals. The goal is to have at least 9,500 diabetes educators incorporate the Conversation Map tools into their diabetes education programs within the next three years.

Conversation Map tools combine visual learning techniques and active dialogue between patients and healthcare professionals to engage patients in sustainable behavior change. The Conversation Map tools help patients to decipher the complexities of diabetes, empower them to draw new insights for better disease management, and inspire them to develop a personal plan for change. The underlying philosophy of the approach is that patients will make better healthcare decisions when they self-determine why change is necessary, what has to change and who else needs to be involved in the change process.

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2. Disease Management Q&A: Establishing a Telephonic Presence

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Dr. Richard Citrin, Ph.D, MBA, vice president of EAP Solutions, a part of the University of Pittsburgh Medical Plan.

Question: What are the best strategies for improving rates of returned calls to case managers?

Response: A key strategy is to build client relationships, beginning with the first contact. Personalizing phone relationships between the health coach or case manager and the individual improves return rates, plus building a personalized relationship from the start results in more returned phone calls.

Our biggest challenge here is our relative inability to leave messages on members' answering machines. You may reach a family member, want to leave a message and not be able to do so depending on Health Insurance Portability & Accountability Act (HIPAA) guidelines. In other cases, the challenge is deciding what to do if you reach a family member instead of the patient.

It is permissible in some programs to leave messages with family, assuming the patient signed a HIPAA release, but we're still cautious about releasing personal information and treatment recommendations. Most family members would welcome the opportunity to take those messages, but our privacy requirements prevent us from doing that.

For more details on theories of behavior modification, sustaining health behavior change and addictive case management, please visit:

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

3. HealthSounds Podcast: Integrating Health Coaching Into a Comprehensive Health Management Effort

In this week's Disease Management podcast, Dr. Susan Butterworth, director of health services at Oregon Health & Science University, describes how to help patients prepare for coaching and subsequently recognize when a patient is ready for self-management. She then discusses the elements of motivational interviewing training, including certification, requirements and benefits. Roger Reed, executive vice president for marketing operations at Gordian Health Solutions, describes the quality checks built into his organization's coaching initiatives, the immediacy of cash incentives in effecting behavior change, and the value of the "accountability factor" in health coaching.

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4. Retirees Benefit from HRA-Driven Wellness Programs

Wellness programs aimed at retirees can reduce individual healthcare costs by hundreds of dollars a year, according to a new study from Thomson Medstat. Healthcare costs were found to be between $101 and $648 less per year for Medicare recipients who participated in employer-sponsored wellness programs that involved the use of a health risk assessment (HRA).

According to the study, HRAs are the guiding force for a successful wellness program. Those who participated in the HRA plus one other program element — such as telephone-based lifestyle management counseling or on-site medical screenings — had average annual savings of $442. Using the health risk assessment with two additional elements resulted in annual savings of $569. In contrast, using such services without guidance from the HRA yielded savings of only about $30 per year, suggesting that knowledge obtained from the HRA may have focused retirees on the health promotion programs that were best suited to them.

The analysis accounted for the confounding impacts of age, gender, job type, location, health status and total payments observed in the first year. Through further statistical testing, the study found that various lifestyle factors could increase the cost savings to $648 per beneficiary. By removing all outlier medical costs from the analysis, researchers saw a lower cost savings of $101 per beneficiary.

To learn more about the findings of this study, please visit:

5. Changing Lives with Lifestyle Management: Taking the Pulse of Population Health Programs

Healthcare organizations are using lifestyle management programs to help patients with chronic conditions modify unhealthy behaviors. In a recent online survey, employers, providers and health plans discussed lifestyle management program development within their organizations. This executive summary explores the differing approaches and techniques in population identification, treatment and outcome assessment.

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