Independent, timely business intelligence on disease and demand management
Volume 11, Number 19
October 10, 2006
Programs provide information on hospice, palliative care options
Health plans, disease management vendors
add end-of-life counseling to services
Health plans and disease management (DM) vendors increasingly are
incorporating end-of-life planning
and services into their care-management programs in an effort to provide terminally ill patients with the
information and tools they need to
make difficult decisions.
The moves by Aetna, Inc., CIGNA
HealthCare, and other organizations
focus attention on what constitutes
quality end-of-life care and also
point out lapses in the overall healthcare system.
“End-of-life care is generally
a bit of a problem throughout the
healthcare system,” says Randall
Krakauer, MD, national medical
director for Aetna’s retiree markets.
“Providers are oriented to curative
diagnosis and therapy, and less [to]
providing emotional support and
discussions of options in terminal
illness. As a result, what we might
define as quality of care in terminal
illness is a weakness in the system.”
An end-of-life care–management
program should provide comfort, palliative care, and emotional support, he
says. However, “discussions [about
such care] usually start very late in
the process,” and as a result, good
end-of-life care does not start until
“the very end or too late,” he adds.
Nationally, only 25% of deaths occur at home, even though more than
70% of Americans say home is where
they would prefer to die, according
to the Robert Wood Johnson Foundation. The Journal of the American
Medical Association has reported
that many people who die in institu-
Health Dialog creates services to
help plans build own programs
With health plans moving toward
building their own disease management (DM) services rather than buying them from vendors, Health Dialog
hopes to position itself as a vendor that
can help plans create their own DM
programs, Chair and CEO George
Bennett tells DMN.
To that end, Health Dialog has created a state-of-the-art software system, known as C3, and will either
license the software to clients, build
a turnkey operation for health plans,
or run the whole program for the
payer, Bennett says.
Health Dialog’s strategy plays
into what industry insiders are calling a new move toward insourcing
DM programs. The move—which
affects mainly large and mediumsized health plans—is part of an
overall shift toward incorporating
more wellness and “whole person”
services into care-management programs that include DM and a host
continued on p. 4
tions have unmet needs in the areas
of symptom amelioration, physician
communication, emotional support,
and being treated with respect. In
addition, medical experts agree that
at least 90%–95% of all serious pain
can be safely and effectively treated,
yet at least half of all dying patients
report experiencing pain.
Patients need at least 60 days of
hospice care to maximize the benefits of hospice, according to the National Hospice and Palliative Care
Organization, the oldest and largest
nonprofit membership organization
in the country representing hospice
and palliative care programs and
professionals. However, the median
length of stay for hospice patients
was 20.5 days in 2001.
continued on p. 2
IN THIS ISSUE
Matria plans to sell its
diabetes service operations
in Germany.................................. 3
Joslin and Walgreens
ally to provide services
to diabetics.................................. 6
Survey shows growth
in employers’ confidence
in DM and wellness
programs ..................................... 7
DM News Briefs.......................... 8
O C T O B E R
End-of-life counseling
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continued from p. 1
Aetna debuts program
In April 2004, Aetna announced
a comprehensive new program of
expanded benefits, nurse case management, and information to help
members and their families cope
more effectively with the issues
involved in care at the end of life.
The Compassionate Care package,
which Aetna made available to several of its customers in January 2005,
includes broadened coverage for hospice and palliative services, and also
provides coverage for curative care
while in hospice.
The program also provides coverage for respite- and bereavementcare services.
The company initially offered the
program to several large plan sponsors representing more than 400,000
members and hopes to expand the
program eventually. Medicare Advantage members are eligible for
counseling on end-of-life challenges from case-management nurses,
but not for the extra benefits.
The Aetna Compassionate
Care program case-management
services are used by nearly 1% of
Aetna’s Medicare population—or
just more than 1,000 Medicare members—annually. Identification of
potential candidates for the program
isn’t straightforward, says Krakauer,
who adds that Aetna may be missing cases, particularly because 50%
of terminal illnesses are not cancer,
and these illnesses can be harder
to identify.
“We identify cases up front
through predictive modeling, then
concurrent review,” Krakauer says,
adding, “A very large portion of terminal illness cannot be identified
through hospitalization anymore.”
Aetna then verifies the case
through the physician’s office and
“goes through the process of engaging with the physician, patient, and
family,” he says. “We need to make
sure they understand where they are
and what their options are.”
Those options can include the
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types of therapy they want and don’t
want, the legal issues involved (e.g.,
living wills and advance directives),
support structures, and Medicare
hospice benefits, says Krakauer.
“We will help them, guide them
through the process, and stay with
them,” he says.
The Compassionate Care program,
which Aetna developed with the National Hospice and Palliative Care
Organization, trained Aetna’s nurse
case managers to
• assess and manage members’
care in a culturally sensitive
manner
• help improve pain and other
symptom management
• improve continuity of care
• improve advance-care planning
• expand personal support
• encourage better use of community-based services and resources
Aetna does not attempt to persuade
Medicare beneficiaries to choose hospice, Krakauer says.
“We’re not pushing, selling, or
marketing hospice—we’re just presenting alternatives,” he says. “But
the number who elect hospice is considerably greater than in the Medicare fee-for-service population. A
much larger fraction of the population will choose hospice and will be
in hospice longer.” Nearly 600 members who were in the Compassionate
Care program died in 2005.
More than 75 of those members
who died while in the program elected hospice care, a rate that well exceeds the national average, Krakauer
says. Only 20% of all Americans die
in hospice, according to the Project
on Palliative Care Law of the Bazelon
Center for Mental Health Law in
Washington, DC. “If you do surveys
of healthy people and the question is
posed, ‘Would you want hospice care
if you were terminally ill?’ Seventyfive percent say yes,” he says.
Patient satisfaction with the casemanagement process surrounding
end-of-life care in the Compassionate
D I S E A S E
Care program “is stratospheric,” he
adds. “The amount of feedback we
get is dramatic.”
CIGNA launches effort
“We see the whole issue of palliative care and end-of-life care as very
important,” says David Ferriss, MD,
national medical executive of clinical program development at CIGNA
HealthCare. He notes that CIGNA
supports end-of-life decision-making through its case-management
capabilities.
“All case managers have knowledge of the resources and can support members,” Ferriss says. This
support can include making members aware of the benefits and involving a behavioral health expert,
if necessary, he says.
CIGNA is taking steps as part
of its new in-house oncology disease-management program to significantly expand the information
and resources available to members
regarding palliative care and endof-life options, says Ferriss. That
information will be available online and in targeted mailings.
The oncology program is available
for plan contracts that take effect beginning January 1 and includes access
to specialized nurses, health educators, and behavioral-health experts
who will assist members in understanding treatment options and coping
with lifestyle issues related to cancer.
CIGNA hopes to work with notfor-profit entities on end-of-life
issues such as patient advocacy,
patient education, and certification
of facilities providing direct services, says Ferriss.
“We also have plans—beginning
with the new oncology program—
to significantly enhance the training
we provide to the group of case managers who can develop real expertise
[in end-of-life issues], so we can really be of additional assistance to members and their families,” he says.
The end-of-life program is aimed
at oncology patients, but Ferris says
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“there’s no reason why we wouldn’t
extend this to other diseases, as long
as we have case managers who have
dealt with end-of-life issues.”
Health Dialog, Matria dive in
DM vendors also are incorporating end-of-life counseling into their
services.
For example, at Health Dialog
care managers encourage end-of-life
planning “by building confidence
that this is something you can plan
for, and by building knowledge about
end-of-life care options [e.g., curative, palliative, and hospice care],”
says CEO George Bennett.
Bennett notes that Health Dialog
also supplies “decision aides” in the
form of Web modules, DVDs, and
videotapes that can help facilitate
end-of-life decisions and planning.
At Matria, Inc., “we are asked by
health plan clients to ask patients
if they have advance directives in
place,” says Graham Cherrington,
senior vice president of operations
for health enhancement. “That dis-
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cussion alone may yield additional
discussions with the patient” regarding end-of-life wishes, he says (see
“Matria to sell German diabetes service operations” below for information about Matria’s plan to sell its
German operations.)
End-of-life decisions are extremely personal, and care managers need
to respect that, Cherrington says.
Matria’s nurses are trained to
determine the best time to initiate
a discussion about options, he says.
“We try and introduce concepts they
need to think about. The patient really is the one—with [his or her] family—to make the decisions and be at
peace with them.”
Krakauer notes that moving patients into hospice potentially can
save money for payers (e.g., Medicare) but that’s not the primary reason to do it.
“There is some possible opportunity for the entire healthcare system
and Medicare in particular to save
money on this,” he says. “But clearly
the driver and urgent need here is the
quality of care for persons with terminal illness.”
Aetna counsels members on
hospice even though hospice may
cost the organization money, says
Krakauer. In fact, “when one of our
members elects hospice, [his or her]
premium goes down by approximately 85%,” he says. In Medicare, the
hospice benefit is a carve-out, he
explains; Medicare pays the hospice
directly and the health insurer loses
most of the premium.
Still, “they’re not going to be
profitable for us after they’ve selected hospice,” Krakauer says. “We’re
doing this because it’s the right thing
to do.” c
Contact: Aetna spokesperson
Susan Millerick, 860/273-0536,
[email protected]; CIGNA
spokesperson Patricia Caballero,
201/533-5028; Health Dialog
spokesperson Kiran Ganda, 617/
406-5239, ganda@healthdialog.
com; and Matria spokesperson
Rich Cockrell, 770/767-4500.
Matria to sell German diabetes service operations
Matria Healthcare, Inc., said
September 25 that it has signed an
agreement to sell Dia Real, its diabetes service operations in Germany.
The buyer is a subsidiary of
OPG Groep NV, a Netherlandsbased public company that specializes in retail and distribution
for pharmaceuticals and medical
supplies.
The transaction, valued at approximately $33 million, has been
approved by the boards of directors
of both companies and is subject to
German merger control clearance,
which is expected later in October.
The transaction completes the
divestiture of the businesses that
were not part of Matria’s core business strategy in the disease management and wellness market, says
Matria Chair and CEO Parker Petit.
“With the sale of Dia Real, we
will be entirely positioned as a pure
play in the disease management sector, and [able to] devote our total
resources to accelerating the growth
of our health-enhancement business,”
she says.
Through the combination of the
expected proceeds from the Dia Real
sale, the proceeds from the company’s recently completed sale of Facet
Technologies, and anticipated cash
from operations, Matria says it is on
track to achieve its goal of reducing
its debt by approximately $175 million in the 2006 calendar year.
At the same time, Matria announced that it has been awarded six new
health-enhancement accounts and
has expanded the programs and serv-
D I S E A S E
ices that it provides to five existing
accounts.
Matria’s six new accounts are
with five self-insured employers
and one health plan.
All five of the accounts that
are expanding their Matria services and programs are self-insured employers.
The company reported that the
annualized value of the new accounts, which are expected to begin producing revenue in 2007,
totals $14.4 million.
This represents an increase of
$5.2 million to the 2007 revenue
backlog reported by the company
in August, according to Matria.
Contact: Matria spokesperson
Rich Cockrell, 770/767-4500.
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DM programs
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continued from p. 1
of other services. (For more information, see p. 1 of the September
25 DMN.)
Bennett says Health Dialog has
seen insourcing coming for a long
time and has been developing tools
to help health plans that wanted to
insource their DM and care-management programs.
“What we have been working on
for almost two years now is [building] what we consider a state-of-theart call-management platform,” he
says. “We didn’t even think about it
as a defensive move. We wanted to
make sure we were playing into what
they wanted to buy.”
Health Dialog currently serves 18
million people, 90% of whom are
eligible for the vendor’s “whole-person” spectrum of services. “What
we’re doing is building a platform
that goes all the way from healthyliving support to case management,”
says Bennett.
Those services range from support
for fever in the middle of the night to
more traditional case management,
as well as wellness programs (e.g.,
smoking cessation and weight management). The company has partnered on some of those programs with
organizations such as Free & Clear,
which tackles tobacco dependence,
and WebMD.
Health Dialog has a 24 million–
life database, which it can use for
patient profiling, opportunity analysis (to reduce unwanted variation,
improve clinical care, and reduce
costs), and predictive modeling,
as well as to determine provider
performance.
“It’s the largest [such] database in
the world,” Bennett says. “It’s a real
factor in our analytic work.”
The database is based on Microsoft.net, which Bennett calls “a rich
architecture for data. It’s straightforward to design, and you can use specific screens, called ‘lenses,’ to put in
or take out data. One of the lenses is
for the patients themselves—there’s a
whole birth in the industry of person4
1 0 ,
al health records, and it’s just one
more lens in our database.”
The company now is building a
system in which clients can use the
database with different lenses, says
Bennett. The first lens that Health
Dialog developed was for case-management nurses. Using their lens, or
interaction point with the database,
these nurses can input and read information in the database that’s relevant to their work with patients.
given client would like to use our
economies of scale, they can use it.
The architecture is designed so they
can customize it.”
For example, a client can use 60
of the software’s standard elements
and 10 customized elements, Bennett
says. In that case, Health Dialog will
maintain the entire program—including the customized elements—“but
they’re going to have to pay for it,”
he adds.
“Our data says we’re on
the right track for some
very dramatic results. It
looks like the difference
between the control group
and the intervention group
this time will show a
cumulative effect.”
Three options for plans
As the disease management market moves towards insourcing, Health
Dialog is offering three options for
health plans:
1. Licensing. If health plans want
to license Health Dialog’s software to use in building their own
systems, the vendor will help
them to do that, Bennett says.
Health Dialog will license the
software—known as C3—and
its other intellectual property
assets, including DVDs, videotapes, print material, outreach
materials, recruiting protocols
and materials, and training protocols and materials, so health
plans can develop their own inhouse program.
2. Turnkey program development.
If a health plan wants its own program but doesn’t want to build it
from scratch, Health Dialog can
develop a turnkey, client-specific
proprietary solution for a health
plan that uses its C3 software
architecture and its other intellectual property assets, Bennett
says. Once the vendor creates
the program, the health plan assumes control of the program’s
daily management and pays Health
Dialog an annual license fee for
its intellectual property. “If you
would like me to build you a
‘mini-me’ . . . I will set up a complete running operation and hand
you the key so you can run it
yourself—and you’ll be a licensee,” says Bennett.
—George Bennet
The next lens will be the personal health record lens, which Health
Dialog will release October 14, says
Bennett. “It will never be complete
—there will always be someone else
who wants a lens.”
Health Dialog developed the first
version of this system a year ago for
its own Medicare Health Support
project in western Pennsylvania and
now has implemented the system for
Highmark Blue Shield.
The system can be customized
for different clients. For example,
if client A wants a specific health
coach screen, and client B wants
something different, the system
can handle that, Bennett says.
Health Dialog provides “walledoff ” development teams for the
proprietary elements of a client’s
program, he says.
“This is . . . industrial-strength
software,” says Bennett. “Rather than
just build it for ourselves, we want to
build it so others can use it. If you
want to take advantage of our enormous quantities of scale that we have
with our quantities of lives—if a
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3. Outsourcing. The health plan
can also outsource the care-management service—or major parts
of it—to Health Dialog. This is
“the way the industry has traditionally done it,” Bennett says.
Health Dialog is in “active negotiations with a broad spectrum
of health plans,” each of which wants
a slightly different piece of the program, says Bennett, who adds that
industry interest is wide-ranging. “The
contracts we’re actively negotiating
now for ‘mini-me’ builds and for
licensees are huge.”
Larger health plans are much
more interested in running their
own programs, whether they license the software or have Health
Dialog build it for them, he says.
“But [plans that insure fewer] than
a couple of million lives is very
happy to have it outsourced. And
if they are an aggressive self-insured employer, they’re not interested
in being in the [care-management]
business—they’re interested in
having it outsourced.”
Future outlook
Still, Bennett doesn’t believe
that this new trend of insourcing for
health plans will spell disaster for
the DM vendor industry.
Instead, he sees growth in other
areas, such as Medicare, Medicaid,
and international segments of the
industry.
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In fact, as of presstime, Health
Dialog expects a new report from
the Centers for Medicare & Medicaid Services (CMS) on its Medicare Health Support program in
western Pennsylvania, and Bennett
says the report should begin to show
good results in the pilot’s intervention group.
“Our data say we’re on the right
track for some very dramatic results,”
he says. “It looks like the difference
between the control group and the
intervention group this time will
show a cumulative effect” and indicate that the program is working.
If the results of the pilot continue
to be strong, Health Dialog hopes
that CMS will expand the pilot as
soon as it is legally allowed to do
so—in about two years.
That move will help fuel the DM
industry, Bennett says, regardless of
any moves by major health plans toward insourcing.
“I think we’ll go through perhaps
a decade of outsourcing some and
insourcing some,” he says. “Most
of the huge growth could come in
Medicare,” which the Boston Consulting Group has said could be a $6
billion market within a few years.
“With Medicare, Medicaid, and
international business, there are many
more years of 30% growth left in the
industry,” Bennett says.
Health Dialog had revenues of
$137 million in 2005 and is expecting at least $190 million in 2006, a
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37% growth rate, he says. “Our
organic growth rate exceeds the
growth rate of our main competitors. We are growing very rapidly.
We anticipate another 40%–50%
growth rate in ’07. We see no letup whatsoever.”
Bennett said in early 2005 that
Health Dialog was exploring the
option of going public in 2006, but
now he says those discussions are
not much further along. “Our board
met September 12 and reaffirmed
its intent to go public in about two
years,” he says.
Investment banks with which
Health Dialog has consulted “are
ready to do it now if we want to,”
Bennett says. But Health Dialog
wants to concentrate on growth
instead of pleasing the markets,
he says.
Besides, Health Dialog is “investing $30 million in development this
year, and [is] still cash-flow positive,” he says.
But despite the Health Dialog
board’s intent to take the company
public within about two years, “we
have had suitors flirting with us for
the last 48 months,” says Bennett.
“It could be that one of those would
pull the board off its interest in going public—but several have tried
and none has done it so far.” c
Contact: Health Dialog spokesperson Kiran Ganda, 617/406-5239,
[email protected].
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Joslin, Walgreens ally on diabetes program
Walgreens, the nation’s largest
drugstore chain, and Joslin Diabetes
Center, an affiliate of Harvard Medical School in Cambridge, MA, on
September 19 announced that they
have formed a “sweeping” alliance to
improve health outcomes for Americans with diabetes.
Together, they will deliver wellness, prevention, and educational
programs that they hope will reach
many of the 62 million Americans
who have diabetes or are at risk of
developing the disease.
“There are a lot of ways in which
this is disease management,” says
Alan Jacobson, MD, senior vice
president of Joslin’s strategic initiatives division. “We have created essentially a joint working group of
staff at Joslin and Walgreens. What
we’re bringing to the table is a deep
and extensive knowledge of diabetes. They have the network and their
own expertise.”
The alliance will leverage all of
Joslin’s expertise in diabetes awareness, prevention, and management.
This expertise will be applied across
Walgreens consumer channels, including its nationwide network of
pharmacies, Walgreens.com, and
Walgreens Health Initiatives, its
pharmacy benefit manager.
The program will include various
educational initiatives on several
fronts, including through Walgreens
stores, via Web sites, and through
Walgreens’ already-established disease management (DM) programs,
Jacobson tells DMN.
More than one out of every five
senior citizens has diabetes, and
almost 40% of seniors have prediabetes, according to Joslin, which
means about 23 million Americans
aged 65 and older have the disease
or are at risk.
Nearly 21 million Americans of all
ages have been diagnosed with diabetes, and an additional 41 million
are at risk for the disease.
A cornerstone of the Joslin6
Walgreens program will be the creation of pharmacy-based resources
for diabetes prevention and care.
Working together, Walgreens
and Joslin will design and build enhanced training curricula, continuing
education programs, and practical
support tools that pharmacists can
use to address the most important
needs of patients, from managing
medication regimens to understanding key individual health measures
such as blood pressure and hemoglobin A1c scores.
Part of that work will involve
Walgreens’ existing programs,
Jacobson says. “We’ll be inserting
our knowledge into programs that
are already in place,” he says.
Walgreens also will open a specialty pharmacy on the Joslin campus
under a separate lease agreement.
That pharmacy will open in the first
quarter of 2007, and Walgreens says
it sees the facility as “the flagship of
our presence in the Harvard medical
community.”
The agreement between Walgreens and Joslin spans five years,
and “really speaks to a long-term
commitment to evolve programs,”
says Jacobson. “I envision this as
a multiyear relationship to see the
benefits and to develop the most
interesting programs.”
In the first months of the alliance,
Walgreens and Joslin will launch initial patient education campaigns
delivered through Walgreens pharmacies that carefully target critical
aspects of daily diabetes management
and the prevention of complications.
The campaigns will include education handouts, tips, and tools tailored to specific patient audiences,
including the elderly and ethnic
groups that are disproportionately
affected by diabetes, the two organizations say.
Aspects of the campaign will be
visible on pharmacy prescription inserts, at Walgreens.com, in Walgreens’
Diabetes & You magazine, and via
D I S E A S E
other communication vehicles.
The alliance will “start with the
basics,” Jacobson says. “Over the
next year, we’ll do more pharmacist
education and more Web materials.”
Joslin and Walgreens also are committed to developing breakthrough
approaches over the long-term that
increase access to innovative health
services for people with diabetes.
In-store clinics are key
The companies are interested in
“evolving the concept of in-store
clinics,” says Jacobson. “There’s
an opportunity to look at wellness,
and screening programs can be
done in-store.”
He adds that Joslin has developed
the Joslin Vision Network, a screening program that looks for eye complications of diabetes, which possibly
could be adapted for use at in-store
Walgreens clinics.
The network, a thoroughly validated retinal imaging service offering
patients a pain-free and nondilated
diabetic eye evaluation that facilitates further examination by eye care
specialists to treat diabetic retinopathy and other pathologies, already is
in use at more than 50 clinical sites
in 15 states.
Pharmacies are a great place to
educate patients, Jacobson says,
because “they come to pharmacies
more often than they go to doctors.”
“Call it a strategic alliance,”
he says. “It’s not structured as a
joint venture where there is a single entity.”
Part of the agreement between
the not-for-profit Joslin and pharmacy giant Walgreens “will involve
Walgreens paying us for some of
our activities,” Jacobson says. “They
will be supporting us to do the work
and also through some cross-marketing activities.” c
Contact: Joslin Senior Vice
President Alan Jacobson, MD,
[email protected].
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Employers’ confidence in DM, wellness rises
benefits or increasing employee
contributions.
The second-annual Employer
Opinion Survey on Healthcare,
which polled responses from 1,094
employers nationwide, looks at how
employers view cost-containment
strategies and what they see in the
future for benefits and cost-containment within healthcare.
According to the survey, the most
significant new strategies planned
for employers next year indicate a
growing shift toward incorporating
Employers now believe that disease management (DM) strategies
and wellness programs that incorporate health risk assessments are as
effective at health cost–containment
as are reducing plan benefits and
increasing copayments, a new study
shows.
The survey, conducted by United
Benefit Advisors (UBA) in Indianapolis, indicates that the focus for
many employers has shifted to preventing and managing employee
health rather than solely cutting
programs that stress prevention and
personal health management, wellness programs that incorporate
health risk assessments, and DM
programs that help employees to
manage chronic conditions.
Employers also reported that
DM programs and wellness programs were most effective in containing costs. c
Contact: UBA cofounder David
LoCascio, 317/705-1800, david@
unitedbenefitadvisors.com.
How would you rate the effectiveness of these cost-containment strategies?
Chronic disease
management programs
Wellness/prevention programs
12.1%
Very effective
8.8%
Very effective
Effective
33.3%
Effective
33.4%
Limited
32.7%
Limited
25.6%
4.7%
None
17.2%
Don’t know
0
5
10
15
5.7%
None
20
25
30
26.5%
Don’t know
35
0
5
10
15
20
25
30
35
Source: Employer Opinion Survey on Healthcare, published by United Benefit Advisors, September 2006.
Which of the following active employee health plan cost-control strategies does your
organization currently have in place or plan to have in place for its next plan year?
In place now
Likely next
year
Would like
someday
Need to
know more
No interest
Implement a wellness program with health
risk assessments
16.9%
16.6%
39.0%
17.7%
9.7%
Implement a chronic disease management
program
15.1%
8.4%
39.4%
24.5%
12.6%
Implement different smoker vs. nonsmoker premiums
3.3%
7.3%
47.9%
21.6%
19.9%
Implement a 24-hour nurse hotline or patient
advocate program
31.2%
5.1%
26.7%
19.7%
17.3%
Source: Employer Opinion Survey on Healthcare, published by United Benefit Advisors, September 2006.
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DM NEWS BRIEFS
APS Healthcare’s commercial
division wins 11 accounts
APS Healthcare said September 13 that it won nine new care
management and behavioral health/
employee-assistance program (EAP)
contracts and renewed two of its
large state employee behavioral
health contracts.
The new contracts include a
mix of customer types, such as Taft
Hartley Trust Funds, health plans,
employers in the pharmaceutical and
technology industries, and a local
municipality that selected APS to
deliver stand-alone and integrated
programs, including health and wellness, disease management (DM),
utilization management, behavioral
health care, EAPs and work/life
services.
The new and renewed accounts
represent approximately 700,000
lives, according to APS.
For example, Cerner, a developer of healthcare information technology solutions, selected APS to
provide services designed to support
the specific health needs of the company’s employees and their family
members. These services include
condition management programs for
diabetes, depression, and maternity,
along with comprehensive utilization management and case management services.
The Indiana Comprehensive
Health Insurance Association chose
APS to provide a full array of integrated care management services
that include DM programs for asthma, chronic obstructive pulmonary
disease, heart failure, diabetes, coronary artery disease, hypertension,
hyperlipidemia, and lower back pain,
as well as medical and behavioral
health utilization management and
case management.
HealthMedia offers programs
to Cleveland Clinic workers
HealthMedia, Inc., which supplies
online behavior change interventions,
said September 18 that the Cleveland
Clinic selected it to provide a comprehensive health and wellness campaign
to 48,000 employees and dependents.
The campaign includes health
risk assessments for adults and teenagers as well as a suite of lifestyle
management programs for weight
management, physical activity, healthy
eating, smoking cessation, and stress
reduction.
To increase participation in the
programs, the Cleveland Clinic and
HealthMedia designed an ambitious
communications and incentive program, the organizations say. They
communicated the campaign through
direct mail to employees’ homes,
company e-mail, flyers, and links to
the HealthMedia programs on the
clinic’s intranet.
In addition, the Cleveland Clinic
promoted the program on “Connections,” a live, one-hour broadcast
hosted by CEO and President Delos
Cosgrove, MD. The hallmark of the
campaign is the “wellness lottery,” in
which employees who have completed the health risk assessment are
entered into a monthly drawing for
Contact: APS Healthcare
spokesperson Sarah Clark-Lynn,
800/305-3720.
8
D I S E A S E
prizes (e.g., gift certificates and
entertainment coupons), and into a
quarterly drawing for large items
(e.g., a big-screen television).
Contact: HealthMedia spokesperson Eileen Faas, 734/623-5474.
Complete Care Medical
acquires customer base
Complete Care Medical, Inc., a
Houston-based disease management,
medical supplies, and prescription
pharmaceuticals company, said September 19 that it acquired the 14,000patient customer base, computer and
phone systems, and other assets of a
national mail-order pharmaceutical
business that recently ceased business operations.
The company gave Complete Care
Medical access to its existing customer base of patients and will assist
in converting approximately 100 prescription orders per day, Complete
Care Medical says. It says it is also
working on launching new divisions
designed to deal with specific diseases in the United States and South
America. c
Contact: Martin McIntyre of Market Ideas, Inc., for Complete Care
Medical, 877/295-3981, Ext. 2.
Group Publisher: Matt Cann Executive Editor: Christine Hannan Editor: Jane Anderson
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