Featured Articles                                                   November 2010, Vol. III, No. 7
Health Dialog Introduces Shared Savings Model for Telephonic Care Management

Health Dialog has introduced a shared savings model for its care management program that offers clients a no-risk approach to reducing medical cost trend. Through this new offering, Health Dialog will provide clients with health management services, including health coaching and decision-support, and will measure savings through a randomized controlled trial (RCT) methodology. Savings demonstrated by the RCT will be shared. A randomized controlled trial of the program was recently published in the New England Journal of Medicine, noting that the intervention netted savings of $6 per member per month.

RCT methodology is the gold standard for measurement in medical research, as it minimizes bias and maximizes validity. Under the shared savings model, all results will be reviewed and validated by a mutually agreed-upon third party.

The Health Dialog program enables high-touch health coaching with high-technology systems to deliver services that cover over 65 conditions, including chronic diseases and conditions with high stakes decisions.

"Health plans and large employers have frequently questioned the value of telephonic health management programs due to inconsistent measurement of savings and return on investment," said David Wennberg, MD, MPH, chief science officer at Health Dialog. "Our Shared Savings model uses the best available measurement methodology combined with risk-free financing to ensure our clients can confidently implement care management solutions."

Get more information here.

Quotable: HRA Functionality

"Initially, HRAs were geared toward individuals learning their numbers and self-care. It then migrated into increased functionality — to inform and invite members to special care management programs. For example, if the individual indicated they were diabetic, had high blood pressure or had coronary artery disease (CAD), the plan sponsor, if they had programs to address those issues, could inform and invite them to the program. Plan sponsors could be employers, health plans or even outside third-party care management vendors. The output from HRAs can even be printed out, faxed or e-mailed to the memberís PCP. This improves the coordination and quality of care."
                                        — Gary Smithson, WorldDoc®

Learn more about benchmarks in HRA use.

Patients with CIGNA CDH Plans More Engaged in Health Coaching, See Decrease in Care Costs

When Americans participate in health coaching and DM programs, substitute generic medications for brand name drugs and avoid unnecessary trips to the ER, their total medical costs went down 15 percent — an average $358 per person in the first year — according to a new multi-year study comparing the healthcare claims experience of 897,000 CIGNA customers in consumer-driven health (CDH) plans, PPOs and HMOs.

The 2010 Fifth Annual CIGNA Choice Fund Experience Study findings show individuals covered by CIGNA Choice Fund CDH plans improve their costs without compromising care by becoming more engaged in improving their health and by becoming informed healthcare consumers:

  • Health coaching and DM program participation: CIGNA CDH plan customers are up to 19 percent more likely to participate in the CIGNA Health Advisor® health coaching program compared to those enrolled in a traditional plan. Individuals with chronic illnesses covered by CDH plans are 21 percent more likely to participate in their planís DM program.
  • Generic medications: CIGNA CDH plan participants who also have CIGNA Pharmacy Management benefits choose generic equivalent drugs 70 percent of the time.
  • Avoiding Unnecessary ER visits: The study also shows that CDH plan enrollees use the ER at a 13 percent lower rate than individuals who have HMO and PPO plans. When CIGNA Choice Fund customers visit an urgent care facility, their doctorís office or convenience clinic instead of the ER, they saved an average of $800.
  • Informed choices: Customers enrolled in a CIGNA CDH plan are more likely to use online information and tools through myCIGNA.com; use of myCIGNA increases by 40 percent when customers are enrolled in a CDH plan. The study also shows CDH plan enrollees are five times more likely to complete a health assessment compared to those enrolled in a traditional plan.

According to CIGNA Chief Medical Officer Jeffery Kang, M.D., "Given the right incentives, the right health improvement programs, useful cost and quality information, and easy-to-understand correspondence, individuals are making rational, wise and successful healthcare decisions."

Read the full article here.

Shared Savings in the Medical Home
The patient-centered medical home is at the heart of Mesa County, Colorado's shared savings model, explains David West, M.D., a hospitalist, family physician and healthcare consultant from Grand Junction, Colorado. Dr. West describes how the shared savings model can be adapted across markets, including the conditions and factors that must be present for this approach to be feasible. He also shares a unique provider incentive that is keeping hospital stays of Medicare patients at less than one-third the national average, one factor that has the nation touting this area as a model for efficient healthcare delivery.

Listen to the podcast here.

New Chart: Case Management ROI

An increase in healthcare case management programs is significantly influencing medication compliance, hospital readmission rates and healthcare costs. We wanted to see what return on investment has been generated by healthcare case management programs.

Click here to view the chart.

Increasing Engagement to Improve ROI

Question: How has your corporation increased engagement in your wellness program?

Response: One way is to promote the initial engagement or participation. We work very closely with our clients to develop effective internal marketing campaigns. This brings awareness about the program and the availability of the program, and then the importance of why one needs to participate in the program. Once an individual becomes engaged and becomes a participant in the program, it is up to the ability of our coach to develop a rapport with that individual to keep them engaged and moving along. One of the ways we do that is by having a primary coach model. In other words, once an individual comes into a program, the coach they are initially assigned to will be their coach for the entire program. That allows our coach and the individual to develop the relationship that may increase the stickiness of the program so the individual remains engaged.

(Jim Reynolds, M.D., chief medical officer for Health Fitness Corporation.)

Learn more about ways to increase patient engagement.

HCH Readers Save 10% on Coaching Resource

Launching a sustainable health coaching initiative requires planning, training, education and evaluation, not to mention creative use of incentives. The Guide to Health Coaching defines the role of the health coach in population health management, provides tactics to motivate individuals to adopt healthier lifestyles, and offers an inside look at health coaching at the Mayo Clinic, including the clinic's use of health IT and incentives to encourage repeat and long-term participation. Q&A chapter answers more than 50 questions on health coaching.

HealthCoach Huddle subscribers should use ordering code HCH to purchase this product at a special price!

Get more information on health coaching initiatives.

2010 Benchmarks in Health Coaching

This white paper captures the ways in which 161 organizations are implementing health coaching in 2010 — including the top three areas targeted by health coaching — as well as the financial and clinical outcomes that result from this health improvement strategy. These benchmarks are based on organizations' responses to the Healthcare Intelligence Network August 2010 e-survey on health coaching.

Download complimentary white paper here.

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