Healthy Solutions for Plan Sponsors Disease Management for Taft

Document Sample
Healthy Solutions for Plan Sponsors Disease Management for Taft Powered By Docstoc
					Healthy Solutions for Plan Sponsors:

Disease Management
for Taft-Hartley and
Multiple Employer Plans
     54%
     Reduction in diabetes
     complications by Cardium
     Health active participants.
                                     All over the country, plan sponsors
                                     are struggling with rising health care costs.
   250%
   The average return on             Today, U.S. employers and other plan
   investment achieved by            sponsors are facing 2006 average cost
   Cardium Health clients.           increases of 8%. Cumulatively since 1996,
                                     the healthcare cost burden has risen by a
   99%                               whopping 140%.1 Today the average cost
   Of participants in                for family coverage is $10,880.2
   Cardium Health disease              The majority of healthcare costs – 70% –
   management programs
   rate services as good
                                     go to just 10% of a plan’s members with
   to excellent.                     diagnosed “chronic conditions.” Diseases
                                     such as diabetes and heart disease are
                                     chronic conditions, which can result in
costly acute care needs if not properly monitored and treated over time.
According to the Partnership for Solutions, 133 million people, almost half of
all Americans, live with a chronic condition. And by 2020, as the population
ages, the number is expected to increase to 157 million.3
   Companies look to solve the problem by shifting more and more of the
cost and responsibility onto workers through higher co-pays, more restrictive
benefit plans, coinsurance, high deductible plans, and the like.4 In turn, plan
sponsors need to respond with win-win solutions to lower costs and deliver real
value for members.
   Disease management offers that win-win solution for plan sponsors. Programs
from Cardium Health help individuals improve their health status – a value
for members – and lower claims costs with favorable net savings – a value for
plan sponsors.
A   H E A L T H Y S O L U T I O N F O R W O R K I N G F A M I L I E S Disease management

is a proven approach that works to improve the quality of care and reduce costs
by addressing the clinical, psychosocial and behavioral needs of individuals with
chronic conditions. Through one-on-one education, health coaches help those
with the greatest need manage their conditions, become better educated
healthcare consumers and use their healthcare benefits properly.



1   2006 Towers Perrin health care survey
2   The Henry J. Kaiser Family Foundation Employee Health Benefits: 2005 Annual Survey
3                                                                                    ,
    Partnership for Solutions, “Chronic Conditions: Making the Case for Ongoing Care” September 2004 update
4   2005 National Survey of Employer-Sponsored Health Plans, Mercer Health & Benefits LLC
   At Cardium Health, we understand that being diagnosed with a chronic disease
or surviving a life-threatening medical event is an extremely stressful, emotional
experience. Once diagnosed, navigating the healthcare system and understanding
complex medical jargon can be challenging for even the most well educated
individuals. Too often, the result is non-compliance with treatment plans, which is
a leading factor of repeat hospitalizations and complications.
   The Cardium Health team of multi-disciplinary health coaches have the clinical
and motivational expertise to encourage people and their families to change their
lifestyle behaviors. They provide the necessary resources to fill the knowledge gap
between your members and their doctors.
   Health coaches take the time to establish trust, provide needed support and
education, and ask questions that ensure understanding. They talk with people in
a comfortable setting and at regularly scheduled times. Over time, individuals
who are active participants in our programs lose weight successfully. They stop
                                                              smoking – and stay
                                                              smoke-free. They
    Disease Management & Health Improvement                   lower their cholesterol
    Programs Cardium Health offers programs to plan           and get their blood
    sponsors that provide members and their families
                                                              pressure to a healthy
    with the knowledge and support they need to better
    manage their health.                                      level. With help and
                                                              support from their
    s Heart Healthy – Cardiac disease management
                                                              health coach,
       for coronary artery disease ( CAD ) and congestive     participants enjoy
       heart failure ( CHF ).                                 stronger relationships
                                                              with their doctors to
    s Healthy Numbers – Diabetes disease manage-
                                                              better understand
       ment for Type I and Type II diabetes.
                                                              their treatment plans
    s Breathe Healthy – Respiratory disease                   and take medication
       management for conditions including asthma and         appropriately. They
       chronic obstructive pulmonary disease ( COPD ).
                                                              improve their physical
    s Back Pain management for acute and chronic              activity levels and are
       back pain.                                             better able to manage
                                                              the stress of everyday
    s Tobacco Cessation program to eliminate nicotine

       dependency.                                            life, and that makes
                                                              for healthy families.
   s   High Blood Pressure / High Cholesterol manage-
       ment to control hypertension and hyperlipidemia.
                                         T A F T - H A R T L E Y   /   M U L T I P L E   E M P L O Y E R   T R U S T S




  A Comprehensive Solution
  Let Cardium Health help you and your members move from knowing to
  doing. Our disease management programs are consistent with the guide-
  lines established by the Disease Management Association of America.
  We provide a proven six-step process guides participants from initial
  identification and enrollment through graduation and self-management.


  Process Steps           Step Focus

1 Identification           Leverage multiple data sources to provide effective
                          data analyses


2 Enrollment              High-touch, on-going outreach to all identified
                          candidates


3 Assessment              Proven algorithm to match the level of participation
                          with the appropriate level of care
                          s   Clinical risk
                          s   Readiness to change
                          s   Health literacy

4 Behavior Change         Real caring for the whole person
                          s   Disease-specific education
                          s   Evidence-based practice guidelines
                          s   Collaborative care including physician and
                              health care services

5 Behavior Maintenance    Participant self-management
                          s   Primary health coach model delivered by a multi-
                              disciplinary team
                          s   Regular patient communication to support behavior
                              modification and monitoring
6 Results
                          All-inclusive clinical measurements with proven,
                          and verifiable financial results
                          s   Routine, real-time program reporting
                          s   Continuous program evaluation
                          s   Ongoing cost containment recommendations
                          s   Direct dollar-for-dollar savings
                                          T A F T - H A R T L E Y                        /   M U L T I P L E   E M P L O Y E R   T R U S T S




                                                Heart Disease Hospitalization Rate*
                                                source: Active Book of Business Result. Pre-Post
                                                Provider/Self Reported Clinical Cost Driver Results.
R E A L C A R I N G As more and more

responsibility for healthcare costs
                                                                               18




                                            events / 100 participants / year
and decisions are being shifted to                                             16   15.2
healthcare consumers, it is important                                          14
for plan sponsors to consider how                                              12                        55% Reduction
changes will affect individuals at all                                         10                        in Hospitalizations
stages of health. What will changes                                            8             6.8
mean to those who are in good                                                  6

health and use fewer services, and                                             4

                                                                               2
what about those with diagnosed
                                                                               0
chronic conditions who require
ongoing care?                                                                        s   pre enrollment
                                                                                     s   post enrollment
   The goal of disease management is
to provide the education, support and       *As a plan sponsor, you may not experience the same
encouragement to motivate individuals        results. Performance results will vary from plan sponsor
                                             to plan sponsor and are contingent upon the number of
to make positive and lasting changes in      program participants.
their lifestyle behaviors.

R E A LR O I Disease management programs from Cardium Health deliver

proven clinical and financial outcomes. Roi is realized in the dollars your plan
doesn’t spend through reduced hospitalizations and new disease complications.
The bar graph above illustrates just one example of the kind of roi Cardium
Health delivers for our customers.


    Disease management is one of
    the best ROI decisions we’ve
    made. Our ROI in the first year
    was 280%. We have
    approximately 25,000 members
    and we care about them.
    Cardium Health’s counselors
    make a difference by connecting
    with people and developing
    relationships. They are great
    listeners and they follow though
    for people who need their help.
    Jim Chitwood
    Executive Director
    G.M.P. Employers Retiree Trust
                                                  T A F T - H A R T L E Y   /   M U L T I P L E   E M P L O Y E R   T R U S T S




 H A P P YM E M B E R S  How do we know that Cardium Health is making a lasting
 difference in the lives of the individuals we touch? They tell us!


                                                           ,
   When you’re a diabetic and your doctor says “insulin” it’s like you’ve failed somehow.
   Before I started talking with Cardium Health, I just thought that somehow it would
   just get better on its own. Today I know how ridiculous that sounds.
      I can’t begin to tell how much better I feel now than I did two years ago. Talking with
   Trisha, she helped me to understand about what the medicine did and how it worked.
   And more important, she helped me to understand what was happening with the
   diabetes and why it made me feel the way I felt.
      I have lost 45 pounds since I started talking with Trisha. It has really given me such
   confidence. I feel so alive and like I have so much more living to do!

   Joy, Brookville, PA



   As a plan sponsor, your members count on you to help protect their health.
 Give them a benefit with real value – real caring disease management from
 Cardium Health. Find out how our programs offer a win-win solution for plan
 sponsors and employers. Call today, 860-677-8900, or read more about Cardium
 Health online at www.cardiumhealth.com.




20 Batterson Park Road   Farmington, CT 06032     860.677. 8900                 www.cardiumhealth.com