CHRONIC DISEASE CARE: CHALLENGES & OBJECTIVES
Control of chronic diseases, such as diabetes, asthma, hypertension and others, is key to keeping an employer’s healthcare costs under control. Most managers are skeptical of the value of programs until they see the results of what you’ve done… – Larry Brown, Sr. V.P. of High IndustriesFirst proven effective in Asheville, North Carolina, this patient centered program focuses on improving the lives of your employees with a chronic disease and, ultimately, reducing an employer’s healthcare costs. The savings, reduced absenteeism and improved health realized in the Asheville model led to the launch of a nation-wide test program, ”The 10 City Program,” sponsored by APA and then to Pennsylvania with the Lancaster Bridge Project.
Allied Benefits has partnered with that group, now called Linking Pharmacists for Improved Health Outcomes, (LPiHO), to bring this unique program and its exciting benefits to employers here in Pennsylvania.
HOW IT WORKS
Participants in the program are each assigned a local pharmacist who acts as the patient’s designated disease management “coach” in face-to-face meetings.
After 40 years as an actuary, this documentation of savings is as good as any I’ve seen… – Dick Burd, Healthcare Actuary; Bridge Project Board MemberPharmacists from a network specially trained, tested and certified by LPiHO, develop individual treatment plans with each participant’s primary care physician. The pharmacists follow a consistent regimen of education, monitoring, data collection and coaching with each patient and communicate progress of each participant to the primary care physician.
Patients receive education on their disease and one-on-one coaching to manage their chronic condition. In addition, participants who volunteer for the program, receive incentives that may include waived or reduced co-pays for the medications, lab tests and supplies needed to treat their disease. Patients do not have to change their existing prescription programs (even mail order), and they do not have to fill their medications or supplies from the pharmacy where they receive the coaching.
WHY IT WORKS
Studies show that only about 50% of people take their medications as directed and poor adherence to medication therapies prevent patients from receiving the full therapeutic benefit of the medications – this is a critical issue for patients with chronic diseases such as diabetes and heart disease, and can lead to significant health risks and high healthcare costs for employers. Having a real person on your side…going back to see the same pharmacist and having them help you stay on the right track, this is the best way I’ve seen to help someone stay on top of things – a proactive health intervention program really helped… – Russ Panico, Quality Assurance Manager, High Steel StructuresThe overall healthcare costs of poor medication adherence have been estimated to approach $100 billion each year.
The Chronic Disease Care Program is a HIPAA-compliant, proactive program that addresses the issue of medication adherence and provides education to the patients through face-to-face coaching by a trained pharmacist working with the patient’s primary care physician.
The Chronic Disease Care Program is completely portable – there is no need to change health care plans or purchase specific products to participate. It is available to any employer and is designed for self-funded employers. There are no mandatory minimum or maximum patient enrollments for employers and the employer may set the criteria for program participation.
EXPECTED OUTCOMES & NEXT STEPS
The Chronic Disease Care Program is a proven way to improve the health of your employees and your bottom line!
Employers invest in the program with one-time enrollment fees for each of the employees who participate, plus fees for the one-on-one coaching and the waived co-pays for medications and supplies. However, the healthcare savings realized by the employers outweigh those costs. In addition, patients (employees) in the program have realized significant improvement to their health and well-being.
Once enrolled, employers receive clinical and economic analysis and reports on the patients in the program – you can view historical information on the program by clicking on the reports listed in the sidebar to the right.
