Improving Patient Safety With Disease Management – Mckesson

Disease Management: Overview What Is Disease Management? Disease management (DM) programs provide an effective way to manage and prevent the further health deterioration of millions of Americans with chronic illnesses—resulting in cost savings for individuals, employers, payors and healthcare providers, according to the Disease Management Association of America (DMAA). DM helps patients understand important self management skills in treating their chronic illnesses to avoid crises in their conditions, which can result in costly emergency department visits or long-term hospital stays. The six components of Disease Management

• Population identification

• Patient self-management

processes

education (may include primary prevention, behavior modification programs, and compliance/surveillance)

• Evidence-based practice guidelines

• Collaborative practice models to include physician and supportservice providers

• Routine reporting/feedback loop

(may include communication with patient, physician, health plan and ancillary providers, and practice profiling)

• Process and outcomes

measurement, evaluation, and management

Although DM today accounts for only .1 percent of overall U.S. healthcare spending (a total of $3 trillion in 2005), widespread adoption of DM programs is expected to significantly increase due to:

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a.

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An aging population Americans 65 years and older will jump to nearly 63 million by 2024 (versus roughly 35 million in 2004) – Centers for Disease Control

Nationwide healthcare cost crises a.

Hospitalizations – many of which are avoidable – are the single most expensive component of healthcare, consuming 33 percent of every dollar spent on healthcare – Agency of Healthcare Research & Quality

b.

Diabetes and its complications is the 6th most costly disease, accounting for estimated $132 billion in direct and indirect healthcare costs in the United States in 2003 – ADA

c.

In 2004, heart failure was responsible for an estimated $25.8 billion in direct and indirect costs – AHA

d.

A 2003 study revealed the annual cost to treat asthma was $4,900 per person – The Journal of Allergy and Clinical Immunology

Increases of chronic diseases a.

54 million Americans are at risk for diabetes – American Diabetes Association

b.

5 million Americans are living with heart failure and 550,000 new cases are diagnosed each year – American Heart Association

c.

From 1982 to 1995, cases of asthma in the U.S. have jumped by over 61 percent. Today, 17 million Americans suffer from the lung disease – American Lung Association

DM Benefits Individuals

Payors (Insurers)

Employers

Healthcare providers

- Longer, healthier lives - Improved knowledge about chronic illnesses - Helpful tools and resources to better manage chronic illnesses - Reduced costs of care -Improved Medication

- Prolonged life and improvements in quality of life for program participants - Greatly reduced costs of providing healthcare as a result of fewer avoidable emergency department visits and hospital admissions

- Fewer employee sick days - Increased productivity due to better health of employees - Reduced healthcare budgets

- Complementary treatment for patients - Support in managing complex patients - Decreased no-show rates for appointments - Improved adherence to treatment plan - Consistency of care

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How DM Works Below is the typical structure of a DM program:

– Identify patient – Patient agreement to participate

– Initial health assessment

– Develop care

management plan

– Identify and engage

– Follow-up visits – Follow-up phone calls – Assess self-monitoring and symptoms – Patient education – Communicate with providers

– Patient and provider satisfaction – Quality assurance – Process evaluation – Optimize program outcomes

– End service – Inform payor and/or provider

providers

– Patient education

Source: South Carolina Heart Center, Piper Jaffray & Co

How McKesson Helps As the largest DM contractor for state Medicaid Fee-for-Service plans and the recipient of multiple awards from DMAA, McKesson Corporation has a proven track record of improving the overall health of people with chronic diseases, reducing costs by decreasing avoidable hospitalizations, and improving clinical outcomes. Through a combination of technology and services, McKesson provides industry-leading DM programs to the top 25 managed care organizations, 90 percent of Blue Cross Blue Shield plans, 15 state Medicaid agencies and more than 160 million Americans. McKesson’s approach to DM complements the care provided by physicians. McKesson believes that DM is most effective with integrated communication between a patient, doctor and the care-givers involved in the DM programs. In fact, if a patient does not have a primary care physician, McKesson will work with the patient to identify one. Also unique to McKesson are the company’s triage and care coordination services. Most DM programs focus on proactive care and communication, but McKesson’s triage services offer reactive support for clients as well. By offering DM program participants an additional means of healthcare advice—whether the symptom, ailment or psychosocial need is related to the person’s chronic illness or not— McKesson’s qualified nurses can help patients determine the severity of their conditions.

McKesson has helped states and healthcare providers save money and improve the quality of health of millions of patients in the United States.

• A 2004 study published in the peer-reviewed Journal of the

American Geriatrics Society showed that MediCare+Choice members with heart failure who participated in McKesson’s CareEnhance Disease Management Heart Failure Program experienced a significant decrease in hospitalizations (23 percent less); 22 percent fewer emergency department visits; 45 percent reduction in 30-day readmission rates; and 45 percent less skilled nursing facility bed days.

• Research published in Disease Management in 2005 revealed that participants in McKesson’s CareEnhance Asthma disease management program had fewer hospitalizations, bed days and emergency department visits compared to a matched group of non-participants.

• In 2005, the Oregon Department of Human Services reported that McKesson DM services saved the program $6 million year-over-year.

• A recent McKesson study of people who participated in the

company’s asthma DM program found: 162 percent increase in patients with action plans; 29 percent increase in patients with preventive medication prescriptions; 17 percent increase in the use of inhaled corticosteroid daily controllers; 100 percent increase in annual flu shots received; and 70 percent owned a peak flow meter.

For more information on McKesson’s disease management programs, please visit: www.mckesson.com

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